Michalek-Sauberer A, Wildling E, Pusch F, Semsroth M
Department of Anaesthesiology and General Intensive Care (A), University of Vienna, Vienna General Hospital, Austria.
Eur J Anaesthesiol. 1998 May;15(3):280-6. doi: 10.1046/j.1365-2346.1998.00284.x.
Forty-two children (aged 2-16 years) were randomly assigned to receive either sevoflurane (n = 21) or halothane (n = 21) in nitrous oxide/oxygen. After pre-medication with midazolam, anaesthesia was induced by facemask and the anaesthetic concentration was increased until loss of eyelash reflex (sevoflurane, 6%; halothane, 2.5%). Thereafter, 1-1.5 MAC of the inhalational agents were maintained until skin closure. Intra-operative analgesia was provided either by intermittent intravenous (i.v.) bolus doses of fentanyl (2-3 micrograms kg-1) or by a regional blockade. Induction was smooth and the time to loss of eyelash reflex was slightly shorter with sevoflurane than with halothane, the difference not quite reaching statistical significance (P = 0.06). In both groups, heart rate remained stable and blood pressure decreased significantly during induction. Haemodynamic parameters remained stable during anaesthetic maintenance; no cardiac dysrhythmias were observed. Emergence time with sevoflurane was 12.9 min vs. 16.3 min with halothane, but this difference was not statistically significant. It is concluded that sevoflurane is as suitable for paediatric patients as halothane. The slightly faster emergence time offered by sevoflurane over halothane was of no clinical significance in the present study.
42名儿童（年龄在2至16岁之间）被随机分配，在氧化亚氮/氧气中接受七氟醚（n = 21）或氟烷（n = 21）麻醉。在使用咪达唑仑进行术前用药后，通过面罩诱导麻醉，并增加麻醉剂浓度直至睫毛反射消失（七氟醚，6%；氟烷，2.5%）。此后，维持吸入麻醉剂1 - 1.5倍最低肺泡有效浓度（MAC）直至手术切口缝合。术中镇痛通过静脉间断推注芬太尼（2 - 3微克/千克）或区域阻滞提供。诱导过程平稳，七氟醚组睫毛反射消失时间略短于氟烷组，但差异未达到统计学意义（P = 0.06）。两组在诱导期间心率均保持稳定，血压显著下降。麻醉维持期间血流动力学参数保持稳定；未观察到心律失常。七氟醚组苏醒时间为12.9分钟，氟烷组为16.3分钟，但该差异无统计学意义。结论是七氟醚与氟烷一样适用于儿科患者。在本研究中，七氟醚比氟烷略快的苏醒时间无临床意义。
