Piat V, Dubois M C, Johanet S, Murat I
Department of Anesthesia, Hôpital d'Enfants Armand Trousseau, Paris, France.
Anesth Analg. 1994 Nov;79(5):840-4. doi: 10.1213/00000539-199411000-00004.
The present study was designed to compare induction and recovery characteristics of sevoflurane and halothane anesthesia in children, and to assess the hemodynamic profile of both anesthetics during induction and maintenance of anesthesia. Thirty-four children (aged 9 mo-9 yr) scheduled for ambulatory surgery were allocated randomly to groups to receive either halothane (HALO, n = 17) or sevoflurane (SEVO, n = 17) in a mixture of O2 and N2O (40:60) for mask induction and maintenance of anesthesia. The inspired concentrations used for inhalation via a mask were increased every five breaths and were successively 1%, 2%, 3%, and 3.5% for HALO and 2%, 4%, 6%, and 7% for SEVO. After tracheal intubation, expired concentration was maintained at 1 minimum alveolar anesthetic concentration (MAC) corrected for age until skin closure. Analgesia was provided by epidural anesthesia using a mixture of plain 1% lidocaine and 0.25% bupivacaine. Induction and recovery characteristics as well as hemodynamic data were recorded. The two groups were identical in age, weight, and duration of anesthesia and surgery. Time to intubation was the same between groups. In the SEVO group, five children exhibited mild excitement, while in the HALO group, one mild laryngospasm and one transient cardiovascular deterioration were observed. In the SEVO group, a significant increase in heart rate (HR) was observed before tracheal intubation, but during maintenance of anesthesia HR and systolic arterial pressure (SAP) did not change compared to control values. In the HALO group, HR did not change throughout the study, whereas SAP remained significantly below control values throughout both induction and maintenance of anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在比较七氟烷和氟烷麻醉用于儿童时的诱导和苏醒特征,并评估麻醉诱导和维持期间两种麻醉剂的血流动力学情况。34例计划行门诊手术的儿童(年龄9个月至9岁)被随机分组,分别接受氟烷(HALO组,n = 17)或七氟烷(SEVO组,n = 17),通过面罩吸入氧气和氧化亚氮(40:60)混合气体进行麻醉诱导和维持。面罩吸入的起始浓度每5次呼吸增加一次,HALO组依次为1%、2%、3%和3.5%,SEVO组依次为2%、4%、6%和7%。气管插管后,呼气末浓度维持在根据年龄校正的1倍最低肺泡有效浓度(MAC)直至手术结束。采用1%利多卡因和0.25%布比卡因混合液行硬膜外麻醉提供镇痛。记录诱导和苏醒特征以及血流动力学数据。两组在年龄、体重、麻醉和手术持续时间方面相同。两组插管时间相同。SEVO组有5例儿童出现轻度兴奋,而HALO组观察到1例轻度喉痉挛和1例短暂性心血管功能恶化。SEVO组在气管插管前心率(HR)显著增加,但在麻醉维持期间HR和收缩压(SAP)与对照值相比无变化。HALO组在整个研究过程中HR无变化,而在麻醉诱导和维持期间SAP均显著低于对照值。(摘要截断于250字)