目的:观察七氟醚吸入麻醉在小儿斜视手术中的应用效果。方法:选择行斜视矫正术的住院患儿60例,ASAⅠ～Ⅱ级,随机分为七氟醚组(A组)和异丙酚瑞芬太尼静脉复合组(B组),每组各30例。A组采取七氟醚合用咪达唑仑、维库溴铵诱导;术中以七氟醚维持麻醉。B组采用异丙酚、瑞芬太尼合用氯胺酮、咪达唑仑、维库溴铵诱导,术中以异丙酚、瑞芬太尼静脉维持麻醉。观察两组患儿插管前、插管时、术中及苏醒期的血流动力学变化;术毕停药后患儿自主呼吸恢复满意时间、拔管时间、意识恢复时间;术中及术后麻醉并发症出现情况。结果:A组插管时心率血压波动较B组大,组间血流动力学变化差异有统计学意义(P<0.05);术中B组患儿血流动力学变化较大,组间血流动力学变化差异有统计学意义(P<0.05);术中眼心反射A组低于B组,组间差异有统计学意义(P<0.01);术后躁动A组更多,组间差异有统计学意义(P<0.01)。结论:七氟醚吸入麻醉用于小儿斜视矫正术血液动力学稳定,可以明显减少眼心反射的发生,苏醒快,但术后躁动发生比例较高。

AIM:To observe the effects of sevoflurane inhalation anesthesia on strabismus operation in children.METHODS:Sixty children of ASA (American society of anaesthetist)grade Ⅰ-Ⅱ were randomly divided into two groups,each group had 30 cases.Group A was treated with sevoflurane,midazolam and vecuronium for induction,sevoflurane for maintenance.Group B was treated with propofol-remifentanil plus ketamine,midazolam and vecuronium for induction,propofol-remifentanil for maintenance.The haemodynamics of pre-intubation,intubation,operation and recovery period were monitored.The time of respiratory recovery,extubation and awareness recovery were recorded.The anaesthetic complication were also recorded.RESULTS:The changes of HR and BP in Group A during intubation increased more than those in Group B,the variances were statistically different between two groups (P <0.05).The variances of haemodynamics were statistically different between Group A and Group B (P<0.05).The eye-heart reflex in Group A was less than those in Group B and the variances were statistically different between two groups (P<0.01).The postoperative agitation in Group A were more than those in Group B and the variances were statistically different (P<0.01).CONCLUSION:The haemodynamics with sevoflurane inhalation anesthesia on strabismus operation in children are stable,and it can significantly reduce the eye-heart reflex.The recovery is more rapidly,but the postoperative agitation is higher.

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