本文選題：芬太尼 + 滴鼻�。� 參考：《上海醫(yī)學(xué)》2015年08期

【摘要】：目的觀察經(jīng)鼻給予術(shù)前藥和麻醉性鎮(zhèn)痛藥并復(fù)合經(jīng)面罩吸入七氟烷這種無創(chuàng)麻醉方法應(yīng)用于小兒單側(cè)霰粒腫切除術(shù)的可行性,并比較不同劑量芬太尼的效果。方法選擇2014年1月-2015年4月于上海交通大學(xué)醫(yī)學(xué)院附屬上海兒童醫(yī)學(xué)中心行單側(cè)霰粒腫切除術(shù)的1~4歲患兒30例,美國麻醉醫(yī)師協(xié)會(huì)(ASA)分級(jí)Ⅰ或Ⅱ級(jí)。所有患兒均先予右美托咪定2μg/kg滴鼻,待患兒改良鎮(zhèn)靜警醒評(píng)分(mOAAS評(píng)分)3分后進(jìn)入手術(shù)室,分別給予患兒芬太尼1μg/kg(1μg/kg組,15例)或2μg/kg(2μg/kg組,15例)滴鼻。15min后,經(jīng)面罩吸入體積分?jǐn)?shù)為0.08的七氟烷麻醉。記錄芬太尼滴鼻前的mOAAS評(píng)分、芬太尼給藥15min后面罩誘導(dǎo)評(píng)分,以及蘇醒時(shí)間和蘇醒期躁動(dòng)評(píng)分。結(jié)果所有患兒均順利完成單側(cè)霰粒腫切除術(shù)。兩組患兒進(jìn)入手術(shù)室前,經(jīng)鼻給予右美托咪定后mOAAS評(píng)分均2分,兩組間芬太尼滴鼻前mOAAS評(píng)分的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2μg/kg組芬太尼給藥15min后面罩誘導(dǎo)評(píng)分顯著優(yōu)于1μg/kg組(P0.05),但兩組間蘇醒時(shí)間和蘇醒期躁動(dòng)評(píng)分的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05)。結(jié)論經(jīng)鼻給予術(shù)前藥和麻醉性鎮(zhèn)痛藥并復(fù)合經(jīng)面罩吸入七氟烷的無創(chuàng)麻醉方法應(yīng)用于小兒眼科短小手術(shù)安全、有效,較大劑量的芬太尼(2μg/kg)滴鼻后患兒面罩耐受度更好。
[Abstract]:Objective to observe the feasibility of preoperative and anaesthetic analgesics combined with sevoflurane inhaled by face mask in the treatment of unilateral chalazal tumor in children, and to compare the effects of fentanyl with different doses.Methods from January 2014 to April 2015, 30 children aged 1 to 4 years were selected from Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine. The ASAs of the American Association of Anesthesiologists were graded 鈪，

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