喉罩通气下七氟醚全凭吸入麻醉在小儿先天性心脏病介入手术的临床麻醉效果

目的:探讨喉罩通气下七氟醚全凭吸入麻醉在小儿先天性心脏病介入手术的临床麻醉效果。方法:选取2017年4月～2019年5月期间我院收治的行先天性心脏病介入手术患儿98例,根据随机数字表法将其分为对照组(n=49)和研究组(n=49)。对照组给予氯胺酮诱导,全凭丙泊酚维持,面罩吸氧;研究组给予全凭七氟醚诱导、维持,喉罩通气。比较两组患儿麻醉前(T0)、切皮前(T1)、切皮后1 min(T2)、切皮后30 min(T3)、术后(T4)的血流动力学指标平均动脉压(MAP)、心率(HR)]及应激反应指标血糖、皮质醇],记录两组患儿手术时间、麻醉诱导时间、术后苏醒时间等围术期指标情况。记录两组围术期不良反应发生情况。结果:研究组手术时间、麻醉诱导时间、术后苏醒时间均短于对照组(P0.05)。两组T0时间点血糖、MAP、皮质醇、HR比较差异无统计学意义(P0.05);对照组T1～T4时间点MAP、血糖、皮质醇、HR均较T0升高(P0.05);研究组T1～T4时间点血糖、MAP、皮质醇、HR与T0时间点比较无差异(P0.05);研究组T1～T4时间点血糖、MAP、皮质醇、HR低于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:小儿先天性心脏病介入手术中应用喉罩通气下七氟醚全凭吸入麻醉,诱导迅速且安全、术后苏醒快、手术时间短,可有效维持血流动力学稳定,减少应激反应。

Anesthesia Effect of Sevoflurane Inhalation Under Laryngeal Mask Ventilation in Children with Congenital Heart Disease

ABSTRACT Objective: To investigate the effect of sevoflurane inhalation anesthesia under laryngeal mask ventilation in children with congenital heart disease. Methods: From April 2017 to May 2019, 98 children with congenital heart disease who underwent interventional surgery in our hospital were selected, They were divided into control group(n=49) and study group(n=49) according to the method of random number table. The control group was induced by ketamine, maintained by propofol and inhaled oxygen by mask, the study group was induced and maintained by sevoflurane and ventilated by laryngeal mask. The hemodynamic indexes(mean arterial pressure (MAP), heart rate (HR)) and stress response indexes (blood glucose, cortisol) of the two groups of children before anesthesia (T0), before skin cutting (T1), 1 min after skin cutting (T2), 30 min after skin cutting (T3), and after surgery (T4) were compared. The perioperative indicators of the two groups, such as operative time, anesthesia induction time, postoperative wake time and others of the two groups were recorded. Adverse reactions in the two groups were recorded perioperative period. Results: The operation time, anesthesia induction time and postoperative wake time of the study group were shorter than those of the control group(P<0.05). There was no significant difference in blood glucose, MAP, cortisol and HR between the two groups at time point T0(P>0.05). The MAP, blood glucose, cortisol and HR of the control group at T1-T4 time point were higher than those of T0(P<0.05). The blood glucose, MAP, cortisol and HR of the study group at T1-T4 time point had no statistical significance compared with T0 time point(P>0.05). The blood glucose, MAP, cortisol and HR of the study group at T1-T4 time point were lower than those of the control group at T0 time point(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Sevoflurane under laryngeal mask ventilation can be induced quickly and safely, and the postoperative recovery time is short. It can effectively maintain hemodynamic stability and reduce stress response.