静吸复合麻醉与全凭静脉麻醉在小儿腹腔镜手术中的应用对比分析

Application of intravenous inhalation combined anesthesia and intravenous anesthesia in pediatric laparoscopic operation

摘要:

目的  探究并分析静吸复合麻醉与全凭静脉麻醉在小儿腹腔镜手术中的应用。方法  选取2013年10月-2014年12月北京市通州区妇幼保健院小儿外科收治的210例需行腹腔镜手术的患者，采用随机数字表法分成观察组和对照组，每组105例患儿。观察组患儿采用丙泊酚瑞芬太尼全凭静脉麻醉的麻醉方案，对照组患儿采用瑞芬太尼及七氟醚静吸复合麻醉方案。分别对患儿经不同方式麻醉后的手术时间、麻醉时间、苏醒时间和麻醉起始至切皮时间进行记录和分析，并对两组患儿并发症的情况进行比较。结果  观察组患儿苏醒的平均时间为（7.1±3.2）min，对照组患儿苏醒的平均时间为（16.4±3.5）min，观察组明显低于对照组；观察组麻醉起始至切皮的平均时间为（11.1±2.1）min，对照组患儿麻醉起始至切皮的平均时间为（10.1±2.9）min，差异无统计学意义（P >0.05）。观察组患儿发生恶心呕吐和术后烦躁的患者人数明显低于对照组，差异有统计学意义（P < 0.05）。结论  丙泊酚瑞芬太尼全凭静脉麻醉的方法应用于小儿腹腔镜手术可减少患儿术后恶心呕吐和烦躁等并发症的发生，减轻患儿的痛苦，值得临床推广。

Abstract:

Objective To explore and analyze the application of intravenous inhalation combined anesthesia and intravenous anesthesia in pediatric laparoscopic operation. Methods Total 210 infants in pediatric surgery of our hospital from 2013 October to 2014 December were selected, and were randomly divided into observation group and control group. Each group had 105 cases. Observation group was treated by propofol isoflurane intravenous anesthesia, and control group was treated by remifentanil and sevoflurane anesthesia. Two groups' operation time, anesthesia time, recovery time and the time from anesthesia started to skin incision after different anesthesia were recorded and analyzed, and two group's complications were compared. Results The average resuscitation time of observation group (7.1 ± 3.2) min was obviously shorter than (16.4 ± 3.5) min of control group; the average time from anesthesia started to skin incision of the observation group (11.1 ± 2.1) min was obviously longer than (10.1 ± 2.9) min of the control group (P < 0.05), with statistical significance. The incidence of respiratory inhibition of observation group was significantly higher than the control group, the number of patients with irritable nausea or vomiting observation group was significantly smaller than the control group (P < 0.05 ), with statistical significance. Conclusions Propofol and isoflurane anesthesia not only can decrease the occurrence of nausea, vomiting and restlessness complications in laparoscopic operation of infants, but also can reduce the pain of the patients.