七氟烷吸入麻醉在小儿下肢骨折手术中的应用及对血流动力学的影响

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摘要目的探讨七氟烷吸入麻醉在小儿下肢骨折手术中的应用效果及对血流动力学的影响。方法选择2017年6月～2020年7月于珠海市妇幼保健院麻醉科行下肢骨折手术的103 例患儿为研究对象。按照随机数字表法分为对照组（51 例）和观察组（52 例）。对照组采用氯胺酮基础麻醉，观察组采用七氟烷吸入麻醉。比较两组患儿血流动力学指标、麻醉质量及不良反应发生情况。结果两组患儿麻醉诱导前血氧饱和度（SaO2）、平均动脉压（MAP）、心率（HR）、收缩压（SBP）、舒张压（DBP）比较，差异无统计学意义（P＞0.05）；观察组睫毛反射消失、切皮即刻、切皮后5 min 时SaO2、MAP 高于对照组，HR、SBP、DBP 低于对照组，差异有统计学意义（P＜0.05）；观察组术毕时SaO2、MAP 高于对照组，差异有统计学意义（P＜0.05）；两组术毕时的HR、SBP、DBP 比较，差异无统计学意义（P＞0.05）；观察组感觉阻滞起效时间、苏醒时间短于对照组，差异有统计学意义（P＜0.05）；观察组不良反应总发生率低于对照组，差异有统计学意义（P＜0.05）。结论七氟烷吸入麻醉可缩短小儿下肢骨折手术患儿麻醉阻滞起效时间与苏醒时间，降低麻醉相关不良反应发生率，稳定血流动力学。

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	尹志伟

关键词 ：七氟烷, 吸入麻醉, 下肢骨折, 血流动力学

Abstract：Objective To explore the application of Sevoflurane inhalation anesthesia in the operation of pediatric lower extremity fractures and its effect on hemodynamics.Methods A total of 103 children who underwent lower limb fracture surgery in the Department of Anesthesiology,Zhuhai Center for Maternal and Child Health Care from June 2017 to July 2020 were selected as the research subjects.They were divided into control group(51 cases)and observation group(52 cases)according to the random number table method.The control group was given Ketamine basic anesthesia,while the observation group was given Sevoflurane inhalation anesthesia.The hemodynamic indexes,anesthetic quality and adverse reactions of the two groups were compared.Results There was no significant difference in blood oxygen saturation(SaO2),mean arterial pressure(MAP),heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)between the two groups before anesthesia induction(P＞0.05).SaO2 and MAP in the observation group were higher than those in the control group,while HR,SBP and DBP were lower than those in the control group when eyelash reflex disappeared,immediately after skin incision and 5 min after skin incision,the differences were statistically significant(P＜0.05).SaO2 and MAP in the observation group were higher than those in the control group at the end of operation,and the differences were statistically significant(P＜0.05).There were no significant differences in HR,SBP and DBP between the two groups at the end of operation(P＞0.05).The onset time and awakening time of sensory block in the observation group were shorter than those in the control group,and the differences were statistically significant(P＜0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Sevoflurane inhalation anesthesia can shorting the onset time and recovery time of anesthesia block in children undergoing lower extremity fracture surgery,reducing the incidence of anaesthesia related adverse reactions,and stabilizing hemodynamics.

Key words： Sevoflurane Inhalation anesthesia Lower extremity fracture Hemodynamics

作者简介: 尹志伟（1984-），男，本科，主治医师，研究方向：临床麻醉

引用本文:

尹志伟. 七氟烷吸入麻醉在小儿下肢骨折手术中的应用及对血流动力学的影响[J]. 中国当代医药, 2021, 28(13): 148-151.
YIN Zhi-wei. Application of Sevoflurane inhalation anesthesia in the operation of pediatric lower extremity fractures and its effect on hemodynamics. 中国当代医药, 2021, 28(13): 148-151.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I13/148

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