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七氟醚与丙泊酚维持小儿外科 1 小时内手术的全身麻醉:一项随机单盲研究。

General Anesthesia Maintained with Sevoflurane versus Propofol in Pediatric Surgery Shorter Than 1 Hour: A Randomized Single-Blind Study.

机构信息

Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, Shandong, China (mainland).

出版信息

Med Sci Monit. 2020 Jun 23;26:e923681. doi: 10.12659/MSM.923681.

Abstract

BACKGROUND Sevoflurane was compared with propofol for general anesthesia maintenance in pediatric operations lasting less than 1 hour in terms of anesthetic effect and postoperative recovery. MATERIAL AND METHODS Children scheduled for inguinal hernia repair or hydrocele testis repair were randomly assigned to receive general anesthesia maintained with either sevoflurane (n=43) or propofol (n=43). The ilioinguinal nerve was blocked with 1% lidocaine (7 mg/kg) after intravenous administration of ketamine (2 mg/kg). At the end of the surgery in patients receiving sevoflurane, sevoflurane was stopped and a bolus of propofol of 1 mg/kg was administered. RESULTS Sevoflurane was associated with significantly less use of ketamine (35.1±10.6 mg) than was propofol (59.0±28.0 mg; P<0.001). In addition, sevoflurane was associated with a significantly shorter time in the post-anesthesia care unit (52.1±9.0 min) than was propofol (68.8±15.3 min; P<0.001). Propofol was associated with a significantly higher incidence of intraoperative body movement (33.3%) than was sevoflurane (13.5%; P=0.045). However, the 2 groups showed no important differences in other adverse events such as hypoxia, emergence agitation, and additional use of propofol. CONCLUSIONS In pediatric surgery lasting less than 1 hour, anesthesia maintained with sevoflurane was associated with significantly less use of ketamine, shorter postoperative recovery time, and less intraoperative body movement than was propofol.

摘要

背景

七氟醚和丙泊酚在小儿手术中均用于 1 小时以内的维持麻醉,本研究比较了两种药物的麻醉效果和术后恢复。

材料和方法

择期行腹股沟疝修补术或睾丸鞘膜积液翻转术的患儿随机分为七氟醚组(n=43)或丙泊酚组(n=43)。静脉给予氯胺酮(2mg/kg)后,行髂腹股沟神经阻滞,给予 1%利多卡因(7mg/kg)。七氟醚组患儿手术结束时停止吸入七氟醚,给予丙泊酚 1mg/kg 负荷量。

结果

七氟醚组患儿氯胺酮的用量明显少于丙泊酚组(35.1±10.6mg 比 59.0±28.0mg;P<0.001)。此外,七氟醚组患儿在麻醉后恢复室的时间明显短于丙泊酚组(52.1±9.0min 比 68.8±15.3min;P<0.001)。丙泊酚组术中体动的发生率明显高于七氟醚组(33.3%比 13.5%;P=0.045)。然而,两组患儿在其他不良反应如低氧血症、苏醒期躁动和丙泊酚的额外使用方面无显著差异。

结论

在 1 小时以内的小儿手术中,与丙泊酚相比,七氟醚维持麻醉可明显减少氯胺酮的使用、缩短术后恢复时间和减少术中体动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5772/7333513/2dd31ebca497/medscimonit-26-e923681-g001.jpg

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