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目的:比较小儿七氟烷麻醉时不同呼气末七氟烷浓度下拔除喉罩的并发症,找到适合拔除喉罩的呼气末七氟烷浓度。方法:2-8岁ASAⅠ-Ⅱ级,行择期手术的患儿60例,依据拔除喉罩时的呼气末七氟烷浓度随机分为三组:Ⅰ组:呼气末七氟烷浓度<=1.4%;Ⅱ组:1.4%<呼气末七氟烷浓度<=2.2%;Ⅲ组:呼气末七氟烷浓度>2.2%。三组患儿均通过喉罩吸入七氟烷,术中保留自主呼吸。记录拔除喉罩时血流动力学变化,氧饱和度,屏气,喉痉挛,舌根后坠等呼吸道并发症。结果:Ⅰ组拔除喉罩时心率和血压明显高于Ⅱ组和Ⅲ组,Ⅱ组和Ⅲ组之间,心率和血压无明显差异;Ⅰ组拔除喉罩时躁动,咬通气道,喉痉挛引起通气障碍的发生率明显高于其他组,Ⅲ组拔除喉罩时舌根后坠引起通气障碍的发生率明显高于其他组。结论:小儿七氟烷麻醉拔除喉罩时较适合的呼气末七氟烷浓度为1.4%-2.2%。
OBJECTIVE: To compare the complications of removal of laryngeal mask at different end-tidal sevoflurane concentrations during pediatric sevoflurane anesthesia and to find the end-tidal sevoflurane concentration suitable for laryngeal mask removal. Methods: Sixty-eight ASAⅠ-Ⅱ patients aged 2-8 years were enrolled in this study. Sixty children undergoing elective surgery were randomly divided into three groups according to their end-tidal sevoflurane concentrations: Group Ⅰ: end-tidal sevoflurane concentration < = 1.4%; Group II: 1.4% 2.2%. Three groups of children were sevoflurane inhalation through the laryngeal mask, intraoperative retained spontaneous breathing. Recorded when laryngeal mask hemodynamic changes, oxygen saturation, breath holding, laryngospasm, tongue root fall and other respiratory complications. Results: The heart rate and blood pressure in group Ⅰ were significantly higher than those in group Ⅱ and group Ⅲ when the laryngeal mask was removed. There was no significant difference in heart rate and blood pressure between group Ⅱ and group Ⅲ. In group Ⅰ, agitation, bile duct and laryngospasm were caused The incidence of ventilatory disturbance was significantly higher than that of other groups. The incidence of ventilatory disturbance caused by the tongue root falling backward in group Ⅲ was significantly higher than that of other groups. CONCLUSIONS: The more appropriate end-tidal sevoflurane concentration in children with sevoflurane anesthesia during laryngeal mask removal is 1.4% -2.2%.