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鼻咽通气道在颌面外科日间小儿吸入麻醉手术中的临床应用

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目的:分析不同麻醉维持方法在颌面外科日间小儿手术中的临床应用效果.方法:纳入颌面外科日间手术患儿80例,按照不同麻醉维持方式将其分为静脉组(n=40):丙泊酚维持剂量为2~3(mg·kg)/h;吸入组(n=40):鼻咽通气道辅助吸入3%~4%七氟醚维持.记录并比较两组患儿局麻后(T1)、术中(T2)、手术结束时(T3)心率、平均动脉压、血氧饱和度,术后苏醒时间及不良反应发生率.结果:不同时间点两组心率变化无统计学差异(P>0.05);吸入组平均动脉压下降幅度低于静脉组(P<0.01);血氧饱和度下降低于静脉组(P<0.01).不良事件统计吸入组发生率低于静脉组(P<0.05).结论:鼻咽通气道辅助吸入麻醉在颌面外科日间小儿手术中镇静效果确切,对循环系统影响较小,降低不良事件发生率.
Clinical application of nasopharyngeal airway in daytime inhalation anesthesia for pediatric patients in oral maxillofacial surgery
Objective:To analyze the clinical application effects of different anesthesia maintenance methods in daytime pediatric sur-gery in oral maxillofacial surgery.Methods:80 children underwent anethesia for daytime surgery in oral maxillofacial region were en-rolled and divided into 2 groups(n=40).The maintenance dose of propofol was 2-3(mg·kg)/h in venous group,that was 3%to 4%sevofluranenas in opharyngeal airway-assisted inhalation group.The heart rate,mean arterial pressure,oxygen saturation,postoperative wake-up time and incidence of adverse reactions after the local anesthesia(T1),intraoperative(T2)and end-of-surgery(T3)were re-corded and compared between the 2 groups.Results:No statistical difference in heart rate change between the 2 groups at different time points(P>0.05).The average arterial pressure decrease and the decrease of oxygen saturationin in the inhalation group were lower than those of the venous group(P<0.01).The incidence of adverse events in the inhalation group were lower than that of the intravenous group(P<0.05).Conclusion:Nasopharyngeal airway-assisted inhalation anesthesia has definite sedative effect in daytime pediatric pa-tients in oral maxillofacial surgery with less influence on the circulatory system and fewer adverse events.

Nasopharyngeal airwayInhalation anesthesiaPediatric patientsMaxillofacial surgeryDay sur-gery

张铁成、程菲、赵严礼、金伟、裴润生、刘桂才

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226001,南通市口腔医院麻醉科

鼻咽通气道 吸入麻醉 小儿患者 颌面外科 日间手术

南通市社会民生科技计划-面上项目

MS22022079

2024

实用口腔医学杂志
第四军医大学口腔医学院

实用口腔医学杂志

CSTPCD北大核心
影响因子:0.942
ISSN:1001-3733
年,卷(期):2024.40(5)