目的:探讨两种麻醉方法在小儿斜视手术中的应用,并比较优缺点。 方法:选择ASAⅠ~Ⅱ级,择期接受斜视手术的患儿32例。随机分为七氟醚、氯胺酮静吸复合麻醉组(A组)和氯胺酮静脉麻醉组(B组)各16例,保留自主呼吸,为保证通气安全,均采用喉罩置入技术。记录摇头、肢体活动和血氧饱合度SpO2〈95%的发生例数、眼心反射(oculocardiac re-flex,OCR)和术后呕吐(postoperati vevomiting,POV)、燥动的发生例数,睫毛反射消失时间、清醒时间等指标。 结果:静吸复合麻醉组患儿接受程度高,血氧饱合度维持好,清醒快,OCR,术后燥动发生率低(P〈0.05),但POV无明显差异(P〉0.05)。 结论:在小儿斜视手术中,七氟醚、氯胺酮静吸复合麻醉优于氯胺酮静脉麻醉。
AIM: To investigate the advantages and disadvantages of sevoflurane inhalational anesthesia combined with ketamine intravenous anesthesia and ketamine intravenous anaesthesia undertaking strabismus surgery in children. METHODS.. Thirty-two children ( ASA Ⅰ-Ⅱ grade) undertaking strabismus surgery were randomly divided into sevoflurane inhalational anesthesia combined with ketamine intravenous anesthesia (group A, n = 16) and ketamine intravenous anaesthesia (group B, n = 16). Laryngealmask airway (LMA) was used to secure respiratory airway. All children breathed spontaneously during operative period. The incidence of SpO2 was less than 95% and the movement of the limbs and head induced by operative stimulation. The revival time, lash reflex extinction time, oculocardiac reflex ( OCR ), postoperative vomiting ( POV ) and postoperative restlessness were recorded in all children. RESULTS: The degree of reception in group A was higher than that in group B, but incidence of postoperative restlessness and SpO2 were less than 95%, OCR and the revival time in group A were less than those in group B. CONCLUSION: Compared with ketamine intravenous anaesthesia, sevoflurane inhalational anesthesia combined with ketamine intravenous anesthesia has better anesthetic quality. It is a new anesthesia method with more advantages in children undertaking strabismus surgery.