论文部分内容阅读
目的观察超快通道麻醉方法应用于小儿腹腔镜疝气手术的安全性和有效性。方法 60例拟在腹腔镜下行疝气手术的患儿作为研究对象,随机分为超快通道麻醉组(U组)和常规麻醉组(G组),每组30例。U组患儿采用喉罩全身麻醉,术中吸入七氟醚维持麻醉;G组患儿采用气管插管麻醉,术中持续泵注丙泊酚、瑞芬太尼维持麻醉。两组机械通气采用压力控制通气(PCV)模式,观察两组患儿插入喉罩或气管导管前(T1)、插入喉罩或气管导管后1 min(T2)、拔出喉罩或气管导管后1 min(T3)时的血压(BP)、心率(HR)、脉搏氧饱和度(Sp O2),并对比两组的手术时间、术毕至拔管时间、麻醉复苏室(PACU)停留时间。结果与T1时比较,T2时G组HR、BP均显著增加,差异均有统计学意义(P<0.05);G组T2时HR和BP均高于U组,差异均有统计学意义(P<0.05)。两组手术时间比较差异无统计学意义(P>0.05);U组术毕至拔管时间(5.1±2.3)min、PACU停留时间(16.2±1.1)min均短于G组的(15.7±2.1)、(25.4±3.5)min,差异均有统计学意义(P<0.01)。结论超快通道麻醉是一种安全、有效的可以用于小儿腹腔镜疝气手术的麻醉方法 ,能够缩短复苏时间,减少住院时间,值得在临床广泛推广应用。
Objective To observe the safety and efficacy of ultra-fast aisle anesthesia in pediatric laparoscopic hernia surgery. Methods Sixty children scheduled for laparoscopic hernia surgery were randomly divided into two groups: 30 cases in each group (group A) and group A (group A). Group U children underwent general anesthesia with laryngeal mask and intraoperative sevoflurane was inhaled to maintain anesthesia. Group G was anesthetized by tracheal intubation and continuous infusion of propofol and remifentanil during anesthesia. The two groups of mechanical ventilation were controlled by the mode of pressure controlled ventilation (PCV). Two groups of children were observed before insertion of laryngeal mask or endotracheal tube (T1), 1 min after insertion of laryngeal mask or endotracheal tube (T2) (BP), heart rate (HR) and pulse oxygen saturation (Sp O2) were measured at 1 min (T3). The operative time, extubation time and PACU residence time were compared between the two groups. Results Compared with T1, the HR and BP in G group were significantly increased at T2 (P <0.05), while the HR and BP at T2 in G group were significantly higher than those in U group (P <0.05). There was no significant difference in operative time between the two groups (P> 0.05). The duration of extubation (5.1 ± 2.3) min and the duration of PACU stay (16.2 ± 1.1) min in group U were shorter than those in group G (15.7 ± 2.1 ), (25.4 ± 3.5) min, the differences were statistically significant (P <0.01). Conclusion Ultra-fast channel anesthesia is a safe and effective method of anesthesia for pediatric laparoscopic hernia surgery. It can shorten the time of resuscitation and reduce the length of hospital stay, which is worth popularizing in clinic.