七氟烷与丙泊酚-芬太尼用于小儿病例喉罩置入的比较。
完整摘要 · 中文译文
目的：喉罩（LMA）是一种常用于儿科麻醉的微创声门上气道装置。静脉注射丙泊酚因其对喉罩置入提供了有利条件而成为常用的优选麻醉药物，而吸入性七氟烷则提供了一种无创诱导，且具有更好的血流动力学稳定性。在丙泊酚中加入芬太尼可通过增强镇痛作用并减弱气道反射，进一步优化置入条件。现有文献主要比较七氟烷与单独使用丙泊酚用于喉罩置入的效果，而七氟烷与丙泊酚-芬太尼联合用药之间的直接比较研究有限，因此开展了本研究。 方法：进行了一项前瞻性、单盲随机研究，纳入60名年龄4-12岁、ASA身体状况分级为I级和II级、接受择期外科手术的儿科患者。采用洗牌法将患者随机分为两组：P组——丙泊酚联合芬太尼组，S组——七氟烷组。P组接受静脉注射丙泊酚（2 mg/kg）联合芬太尼（2 µg/kg 单次推注），并使用氧化亚氮-氧气混合气（2:1）进行面罩通气；S组则使用七氟烷（7%）联合氧化亚氮-氧气混合气（2:1）进行吸入诱导。记录诱导时间、下颌松弛时间及喉罩置入时间。同时监测血流动力学参数及操作相关并发症。 结果：与丙泊酚-芬太尼组相比，七氟烷组的下颌松弛时间显著更长（108.41 ± 6.90 秒 vs 53.35 ± 4.12 秒）。 nds；p < 0.05）。同样，七氟烷组喉罩置入时间显著延长（118.96 ± 6.65 秒对 63.19 ± 4.31 秒；p < 0.05），且七氟烷表现出更好的血流动力学稳定性。 结论：丙泊酚-芬太尼诱导及喉罩置入更快，而七氟烷在儿科患者中血流动力学稳定性更优，且安全性相当。
完整摘要 · 英文原文
PURPOSE: Laryngeal Mask Airway (LMA) is a commonly used minimally invasive supraglottic airway device used in pediatric anesthesia. Intravenous propofol is the commonly preferred anesthetic drug due to its favorable insertion conditions for LMA while inhalational sevoflurane offers a non-invasive induction with better hemodynamic stability. The addition of fentanyl to propofol may further optimize insertion conditions by enhancing analgesia and attenuating airway reflexes. Existing literature predominantly compares sevoflurane with propofol alone for LMA insertion whereas direct comparisons between sevoflurane and propofol-fentanyl combination are limited, hence the present study was undertaken. METHODS: A prospective, single blinded randomized study was conducted in 60 pediatric patients aged 4-12 years with ASA physical status I and II undergoing elective surgical procedures. Using shuffle method, patients were randomly allocated to two groups Group P- Propofol with fentanyl group and Group S- Sevoflurane group. Group P received intravenous propofol (2 mg/kg) with fentanyl (2 µg/kg bolus) along with mask ventilation using a nitrous oxide-oxygen mixture (2:1), while Group S underwent inhalational induction with sevoflurane (7%) using nitrous oxide-oxygen mixture (2:1). Time to induction, jaw relaxation, and LMA insertion were recorded. Hemodynamic parameters and procedure-related complications were also monitored. RESULTS: The time to jaw relaxation was significantly longer in the sevoflurane group compared to the propofol-fentanyl group (108.41 ± 6.90 vs 53.35 ± 4.12 seconds; p < 0.05). Similarly, the time to LMA insertion was significantly prolonged in the sevoflurane group (118.96 ± 6.65 vs 63.19 ± 4.31 seconds; p < 0.05), with sevoflurane demonstrating better hemodynamic stability. CONCLUSION: Propofol-fentanyl provides faster induction and LMA insertion, whereas sevoflurane offers superior hemodynamic stability with comparable safety profiles in pediatric patients.