喉罩联合七氟醚吸入麻醉在小儿舌系带矫正术中的临床应用(1)
摘 要：目的 探討喉罩联合七氟醚吸入麻醉应用于小儿舌系带矫正术中的临床应用效果和安全性。方法 择期行舌系带矫正术小儿60例，分为气管插管组(T组)和喉罩组(L组)两组，每组30例。8%七氟醚+5 L/min氧气诱导，开放外周静脉，静脉注射芬太尼1 μg/kg，罗库溴铵0.3 mg/kg。待脑电双频指数(BIS)达45～50时，T组插入气管导管，L组置入喉罩并在口腔两侧放入纱布，术中调整1.5%～3%七氟醚和2 L/min氧气，维持BIS 40～60。分别记录麻醉前(T1)、置管/喉罩即刻(T2)、手术开始时(T3)、拔管/喉罩即刻(T4)的SBP、HR、ETCO2和SpO2，手术时间、诱导时间、苏醒时间以及患儿术后呛咳、喉痉挛、反流误吸及苏醒期躁动等不良反应的发生情况。结果 两组患儿均没有出现反流误吸。T组术后呛咳8例，苏醒期躁动9例，喉痉挛1例，而L组术后呛咳1例，苏醒期躁动2例，喉痉挛未出现。与T组相比，L组术后呛咳和苏醒期躁动病例数减少，差异具有统计学意义(P<0.05)。与T1比较，T组在T2、T4时点SBP、HR增高，差异有统计学意义(P<0.05)。与L组相比，T组苏醒时间延长，差异有统计学意义(P<0.05)。结论 喉罩联合七氟醚吸入麻醉可安全应用于小儿舌系带矫正术，对小儿呼吸道刺激小，并发症少。
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关键词：脑电双频指数；七氟醚；喉罩；舌系带矫正术
中图分类号：R781.57；R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.028
文章编号：1006-1959(2018)08-0091-03
Clinical Application of Laryngeal Mask Combined with Sevoflurane Inhalation Anesthesia in Correction of Tongue in Children
ZHANG Jin1，WANG Shao-lin2
(1.Institute of Graduate Studies，Southern Anhui Medical College，Wuhu 241000，Anhui，China
, 百拇医药
2.Department of Anesthesiology，Second People's Hospital of Wuhu，Wuhu 241000，Anhui，China)
Abstract：Objective To evaluate the efficacy and safety of laryngeal mask combined with sevoflurane inhalation anesthesia in the correction of tongue in children.Methods 60 children with selective tongue band correction were divided into tracheal intubation group(T group)and laryngeal mask group(L group).30 cases in each group，8% sevoflurane +5 L/min oxygen induction， open peripheral vein， intravenous fentanyl 1 μg/kg，rocuronium bromide 0.3 mg/kg.When the bispectral index(BIS)reached 45 to 50，the tracheal catheter was inserted into the T group，and the laryngeal mask was placed in the L group and the gauze was placed on both sides of the mouth.Intraoperative adjustment of 1.5%～3% sevoflurane and 2 L/min oxygen，maintaining BIS 40～60.Record preoperative anaesthesia (T1)，catheter/laryngeal mask immediately(T2)，at the beginning of surgery(T3)，extubation/laryngeal mask immediately(T4)SBP， HR，ETCO2 and SpO2，operative time，induction time，resuscitation time and incidence of adverse reactions such as cough，throat， backflow aspiration，and agitation during recovery.Results No reflux aspiration occurred in both groups.In group T，8 cases had cough resection，9 cases revived during resuscitation and 1 case had laryngeal fistula.In group L，1 case had cough after operation，2 cases had agitation during recovery，and throat did not appear.Compared with group T，the number of postoperative dysphoria and recovery agitation in group L decreased，and the difference was statistically significant(P<0.05).Compared with T1，T group had higher SBP and HR at T2 and T4 points，the difference was statistically significant(P<0.05).Compared with group L，the recovery time of group T was prolonged，the difference was statistically significant(P<0.05).Conclusion Laryngeal mask airway combined with sevoflurane inhalation anesthesia can be safely applied to correction of lingual frenulum in children., 百拇医药(张进 王绍林)
, http://www.100md.com
关键词：脑电双频指数；七氟醚；喉罩；舌系带矫正术
中图分类号：R781.57；R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.028
文章编号：1006-1959(2018)08-0091-03
Clinical Application of Laryngeal Mask Combined with Sevoflurane Inhalation Anesthesia in Correction of Tongue in Children
ZHANG Jin1，WANG Shao-lin2
(1.Institute of Graduate Studies，Southern Anhui Medical College，Wuhu 241000，Anhui，China
, 百拇医药
2.Department of Anesthesiology，Second People's Hospital of Wuhu，Wuhu 241000，Anhui，China)
Abstract：Objective To evaluate the efficacy and safety of laryngeal mask combined with sevoflurane inhalation anesthesia in the correction of tongue in children.Methods 60 children with selective tongue band correction were divided into tracheal intubation group(T group)and laryngeal mask group(L group).30 cases in each group，8% sevoflurane +5 L/min oxygen induction， open peripheral vein， intravenous fentanyl 1 μg/kg，rocuronium bromide 0.3 mg/kg.When the bispectral index(BIS)reached 45 to 50，the tracheal catheter was inserted into the T group，and the laryngeal mask was placed in the L group and the gauze was placed on both sides of the mouth.Intraoperative adjustment of 1.5%～3% sevoflurane and 2 L/min oxygen，maintaining BIS 40～60.Record preoperative anaesthesia (T1)，catheter/laryngeal mask immediately(T2)，at the beginning of surgery(T3)，extubation/laryngeal mask immediately(T4)SBP， HR，ETCO2 and SpO2，operative time，induction time，resuscitation time and incidence of adverse reactions such as cough，throat， backflow aspiration，and agitation during recovery.Results No reflux aspiration occurred in both groups.In group T，8 cases had cough resection，9 cases revived during resuscitation and 1 case had laryngeal fistula.In group L，1 case had cough after operation，2 cases had agitation during recovery，and throat did not appear.Compared with group T，the number of postoperative dysphoria and recovery agitation in group L decreased，and the difference was statistically significant(P<0.05).Compared with T1，T group had higher SBP and HR at T2 and T4 points，the difference was statistically significant(P<0.05).Compared with group L，the recovery time of group T was prolonged，the difference was statistically significant(P<0.05).Conclusion Laryngeal mask airway combined with sevoflurane inhalation anesthesia can be safely applied to correction of lingual frenulum in children., 百拇医药(张进 王绍林)