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[斜视手术患儿丙泊酚持续输注与安氟醚的比较:麻醉质量及恢复情况对比]

[Continuous propofol infusion versus enflurane in children operated on for strabismus. Comparison of the quality of anesthesia and recovery conditions].

作者信息

Queinnec M C, de Dieuleveult C, Chupin A M, Pinaud M

机构信息

Département d'Anesthésiologie, Hôtel-Dieu, Nantes.

出版信息

Ann Fr Anesth Reanim. 1989;8(1):37-41. doi: 10.1016/s0750-7658(89)80140-6.

Abstract

In children, the use of a continuous infusion of propofol has not yet been reported. A study was therefore designed to compare the characteristics of anaesthesia and recovery when either propofol or enflurance was used as the main anaesthetic agent. All 42 children (14 girls, 28 boys), ASA I and scheduled for corrective squint surgery under general anaesthesia, received 350 micrograms.kg-1 midazolam and 40 micrograms.kg-1 atropine intrarectally 20 min before induction, which was carried out with 3 mg.kg-1 propofol intravenously in 20 s. The patients were then randomly assigned to two groups, according to the drug used for maintenance: group P (n = 21) received a continuous intravenous infusion of propofol, 18 mg.kg-1.h-1 for the first 30 min and 15 mg.kg-1.h-1 thereafter; group E (n = 21) received 2.5%, then, after 30 min, 2% enflurane. Both groups were given 15 micrograms.kg-1 dextromoramide and 0.09 mg.kg-1 vecuronium. During anaesthesia, the following parameters were monitored: systolic (Pasys), diastolic (Padia) and mean arterial (Pa) pressures, heart rate (fc), the presence or not of an oculocardiac reflex with or without a 20% fall in fc which responded to 10-15 micrograms.kg-1 atropine, the appearance of a cardiac dysrhythmia, duration of anaesthesia and the delay before extubation. Recovery was assessed 1, 2, 4 and 6 h postoperatively by using both clinical and psychomotor criteria, the latter being adapted to children having one or both eyes occluded.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在儿童中,尚未有持续输注丙泊酚的报道。因此设计了一项研究,比较以丙泊酚或安氟醚作为主要麻醉剂时的麻醉和苏醒特征。所有42例儿童(14例女孩,28例男孩),ASA I级,计划在全身麻醉下进行斜视矫正手术,在诱导前20分钟经直肠给予350微克/千克咪达唑仑和40微克/千克阿托品,然后在20秒内静脉注射3毫克/千克丙泊酚进行诱导。然后根据维持用药将患者随机分为两组:P组(n = 21)接受丙泊酚持续静脉输注,最初30分钟为18毫克/千克·小时,此后为15毫克/千克·小时;E组(n = 21)接受2.5%的安氟醚,30分钟后改为2%。两组均给予15微克/千克右吗拉胺和0.09毫克/千克维库溴铵。麻醉期间,监测以下参数:收缩压(Pasys)、舒张压(Padia)和平均动脉压(Pa)、心率(fc)、有无眼心反射以及fc是否下降20%(对10 - 15微克/千克阿托品有反应)、是否出现心律失常、麻醉持续时间和拔管前延迟时间。术后1、2、4和6小时,根据临床和精神运动标准评估苏醒情况,后者适用于单眼或双眼被遮盖的儿童。(摘要截断于250字)

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