摘要
目的探讨新生儿全身麻醉气管插管时的最佳七氟醚浓度。方法择期手术的新生儿60例,采用随机数字表法分为1.5MAC组、1.8MAC组、2.1MAC组、2.4MAC组,每组15例。各组均在吸入七氟醚4 min后予行气管插管,记录患儿入室时(T0)、意识消失(T1)、窥喉(T2)、插管后即刻(T3)、插管后1 min(T4)各时点的心率(HR)、血压(MAP),同时记录患儿意识消失所需时间,并进行气管插管评分。结果各组HR比较,差异无统计学意义(P>0.05);各组HR均随着时间变化存在差异(P<0.01);时间与HR之间无交互效应(P>0.05)。各组MAP比较,差异无统计学意义(P>0.05);各组MAP均随着时间变化存在差异(P<0.01);时间与MAP之间无交互效应(P>0.05)。各组意识消失所需时间比较,差异无统计学意义(P>0.05);1.5MAC组插管时躯体运动评分明显高于其余各组(P<0.01),其余各组之间比较差异无统计学意义(P>0.05);与1.5MAC组相比,其余3组声门暴露情况评分明显降低(P<0.01),且评分随着各组浓度的增加逐渐降低(P<0.05)。1.8MAC组插管后呛咳及躯体运动评分较1.5MAC组降低不明显(P>0.05),2.1MAC组插管后呛咳及躯体运动评分较1.5MAC组、1.8MAC组明显降低(P<0.01),2.4MAC组明显低于其余3组(P<0.01)。结论新生儿吸入七氟醚4 min、在呼吸末浓度为2.1MAC时即可达到满意的气管插管条件。
Objective To explore the optimal concentration of sevoflurane for general anesthesia with tracheal intubation among newborns.Methods Sixty newborns undergoing selective operation were divided into 1.5 minimum alveolar concentrations（ MAC） group （n=15）,1.8MAC group（n=15）,2.1MAC group（n=15） and 2.4MAC group（n=15） by random number table.The tracheal intubation was conducted in all groups 4 minutes after inhalation of sevoflurane.Heart rate（ HR） and mean arterial pressure（ MAP） were recorded at following time points：the moment of entering the operation room（T0）,the moment of loss of consciousness（T1）,the moment of performing laryngeal endoscopy（ T2 ） ,the instant of intubation（ T3 ） and one minute after intubation（ T4 ） .The duration for loss of consciousness was also recorded.And the tracheal intubation condition was scored.Results There were no significant differences in HR among four groups（P〉0.05）. HR showed significant difference over time in each group（P〈0.01）.There was no interaction effect between time and HR（P〉0.05）.There were no significant differences in MAP among four groups（P〉0.05）.MAP showed significant difference over time in each group;There was no interaction effect between time and MAP（P〉0.05）.There was no significant difference in the duration for loss of consciousness among four groups（P〉0.05）.1.5MAC group gained significantly higher score of body movement during intubation compared to other groups（P〈0.01）,but no significant difference was observed in the score among the other groups（P〉0.05）.Compared to 1.5MAC group,another three groups obtained significantly lower scores of glottis exposure（P〈0.01）,and the scores decreased gradually with the increasing concentration of sevoflurane in each group （P〈0.05）.There is no significant difference in the scores of cough and body movement after intubation between 1.8MAC group and 1.5MAC group（P〉0.05）.The scores of cough and body movement after intubation in 2.1MAC group were significantly lower than that in 1.5MAC group or 1.8MAC group（P〈0.01）.The scores of cough and body movement after intubation in 2.4MAC group were significantly lower compared to those in another three groups（P〈0.01）.Conclusion Inhalation of sevoflurane for 4 minutes and the end-tidal concentration of 2.1MAC can provide a satisfactory intubation condition.
出处
《广西医学》
CAS
2015年第10期1423-1426,共4页
Guangxi Medical Journal
关键词
七氟醚
新生儿
气管插管
全身麻醉
最低肺泡有效浓度
Sevoflurane
Newborn
Tracheal intubation
General anesthesia
Minimum alveolar concentration
