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[1]何咸兵,周 斌,段家芳,等.静脉全麻联合局部浸润麻醉在小儿眼窝填充术的应用[J].医学研究与战创伤救治(原医学研究生学报),2011,13(05):396-398.
　HE Xian-bing,ZHOU Bin,DUAN Jia-fang,et al.Application of intravenous general anesthesia combined with infiltrated anesthesia in pediatric in the eye socket implant surgery[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(05):396-398.
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静脉全麻联合局部浸润麻醉在小儿眼窝填充术的应用()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第13卷
期数:
2011年05期
页码:
396-398
栏目:
出版日期:
2011-09-20

文章信息/Info

Title:
Application of intravenous general anesthesia combined with infiltrated anesthesia in pediatric in the eye socket implant surgery
文章编号:
1672-271X(2011)05-0396-03
作者:
何咸兵; 周 斌; 段家芳; 孙 浩; 赵建生
210002 江苏南京，解放军81医院麻醉科
Author(s):
HE Xian-bing; ZHOU Bin; DUAN Jia-fang; SUN Hao; ZHAO Jian-sheng
Department of Anesthesiology,81 Hospital of PLA,Nanjing,Jiangsu 210002,China
关键词:
眼窝; 填充; 诱发电位; 听觉; 麻醉; 静脉; 患儿
Keywords:
eye socket; implant;  evoked potential; auditory;  anesthesia; intravenous;  pediatric patient
分类号:
R779.7
DOI:
-
文献标志码:
A
摘要:
目的 观察静脉全麻联合局部浸润麻醉在小儿眼窝填充术围术期麻醉效果与恢复质量。方法 选择ASAⅠ~Ⅱ级择期行眼窝填充手术40例，随机分为两组。A组20例，静脉全麻后联合眼窝深部浸润麻醉；B组20例，静脉全麻。气管内插管后持续输注0.2 μg/(kg·min) 瑞芬太尼以维持麻醉深度。术中通过监测听觉诱发电位指数(AAI)调节丙泊酚输注速率，使AAI维持在20～30，记录入室所测值为基础值(T1)、插管时(T2)、眼窝深部浸润(T3)、术中分离眼窝深部 组织(T4)、术毕(T5)、拔管时(T6)六个时间点的平均动脉压(MAP)、心率(HR)、AAI值及丙泊酚T4点给药速率和全程给药速率。观察两组患儿苏醒拔管时间及术后不良反应情况。记录术前、术后3 h的血糖和血清皮质醇水平。结果 在T4点MAP、HR、AAI值B组明显高于A组，差异有统计学意义(P<0.05 )，术中分离眼窝深部 (T4)点丙泊酚的输注速率及均值，A组明显小于B组，差异有统计学意义(P<0.05 )。与术前相比术后3 h时血糖和血清皮质醇值明显增高，差异有统计学意义(P<0.01 )；A组增高值明显小于B组，差异有统计学意义(P<0.01 )。A组拔管时间小于B组，但差异没有统计学意义(P>0.05 )。苏醒期躁动、恶心呕吐、屏气呼吸道梗阻，A组发生率也明显小于B组，差异均有统计学意义(P<0.05 )。结论 静脉全麻联合局部浸润麻醉对小儿眼窝填充手术，能降低术中静脉麻醉药的用量，有助于术后苏醒，可有效降低应激引起的内分泌和代谢反应。
Abstract:
Objective To investigate the effect of anesthesia and recovery during intravenous general anesthesia combined with infiltrated anesthesia in pediatric patients undergoing implant in the eye socket. Methods Forty ASA class I or Ⅱ pediatric patients undergoing implant in the eye socket were randomly divided into two groups with 20 cases each: in group A,intravenous anesthesia was combined with local infiltrated anesthesia in the eye socket,and total intravenous anesthesia was in group B. Remifentanil was infused at a constant rate of 0.2 μg/(kg·min). Propofol infusion rate was adjusted by auditory evoked potential index (AAI) in all patients. AAI value was maintained from 20 to 30.MAP,HR,AAI value were recorded baseline(T1),intubation(T2),local infiltrated anesthesia(T3),dissolution of the eye socket(T4),the end of operation(T5),extubation(T6),propofol infusion rate were recorded in the T4,the plasma concentration of blood glucose and cortisol in the preoperation and 3 hours of postoperation,the time of restoration to extubation,and the side-effect were recorded. Results The propofol infusion rate in the T4 was significantly slower and the total amount of propofol infused was significantly less in group A than in group B(P<0.05). The time of extubation in group A had no significantly shorter than in group B(P>0.05).The effect of postoperative recovery was better in group A than in group B (P<0.05).Compare the preoperation,the plasma concentration of blood glucose and cortisol was significantly higher in the 3 hours of postoperation,the value of blood glucose and cortisol in the 3 hours of postoperation was significantly less in group A than in group B(P<0.05). Conclusion Intravenous anesthesia combined with local infiltrated anesthesia in pediatric patients undergoing implant in the eye socket can maintain adequate and smooth anesthesia with less side-effect and depress the stress response effectively.

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备注/Memo

备注/Memo:
南京军区卫生专业人才培养“122工程”资助项目(2009025)
更新日期/Last Update: 2011-09-20