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异氟烷单独使用与小剂量丙泊酚复合异氟烷用于儿童喉罩拔除的随机对照试验

Isoflurane alone versus small dose propofol with isoflurane for removal of laryngeal mask airway in children-a randomized controlled trial.

作者信息

Kumar Dileep, Afshan Gauhar, Zubair Muhammad, Hamid Mohammad

机构信息

Department of Anesthesia, Aga Khan University, Karachi, Pakistan.

出版信息

J Pak Med Assoc. 2019 Nov;69(11):1596-1600. doi: 10.5455/JPMA.296240..

Abstract

OBJECTIVE

To compare the safety of laryngeal mask airway removal using two different deep anaesthesia techniques in paediatric patients.

METHODS

The Randomized Control Trial was conducted at Aga Khan University Hospital, Karachi, from April 2012 to November 2013, and comprised patients aged 2-10 years scheduled for infraumbilical surgeries. Anaesthesia was induced with sevoflurane and later it was maintained by is oflurane, oxygen and nitrous oxide. The laryngeal mask airway was removed in the intervention group-I at 0.4 minimum alveolar concentration of isoflurane with propofol 1mg/kg. In the control group-II, it was removed at 1.2 minimum alveolar concentration of isoflurane alone. SPSS 19 was used for data analysis.

RESULTS

Of the 50 patients, there were 25(50%) in each of the two groups. Overall, there were 46(92%) males and 4(8%) females. Incidence of airway obstruction and teeth clenching was significantly higher in group-II (p<0.05 each). Emergence duration was also significantly increased in group-II compared to group-I (p=0.001). The Post-Anaesthesia Care Unit stay timing was not significantly different between the groups (p=0.74).

CONCLUSIONS

Laryngeal mask airway removal under deep anaesthetic technique of low-dose propofol with isoflurane was found to be associated with minimal adverse airway events than isoflurane alone in paediatric patients.

摘要

目的

比较两种不同深度麻醉技术用于小儿患者拔除喉罩的安全性。

方法

2012年4月至2013年11月在卡拉奇阿迦汗大学医院进行随机对照试验,纳入计划行脐下手术的2至10岁患者。采用七氟醚诱导麻醉,随后用异氟醚、氧气和笑气维持麻醉。干预组-I在异氟醚最低肺泡浓度为0.4且丙泊酚1mg/kg时拔除喉罩。对照组-II仅在异氟醚最低肺泡浓度为1.2时拔除喉罩。采用SPSS 19进行数据分析。

结果

50例患者中,两组各25例(50%)。总体上,男性46例(92%),女性4例(8%)。气道梗阻和牙关紧闭的发生率在对照组-II显著更高(均p<0.05)。与干预组-I相比,对照组-II的苏醒时间也显著延长(p=0.001)。两组在麻醉后护理单元的停留时间无显著差异(p=0.74)。

结论

在小儿患者中,低剂量丙泊酚联合异氟醚的深度麻醉技术下拔除喉罩,与单纯使用异氟醚相比,不良气道事件最少。

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