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目的对笑气吸入和靶控输注异丙酚两种镇静方法在小儿埋伏多生牙拔除术中应用进行比较。方法选择择期接受上前牙区埋伏多生牙拔除手术的患儿60例,年龄6岁~14岁,ASA分级Ⅰ级。随机分为两组:P组(异丙酚组,n=30)和N组(对照组,n=30)。异丙酚组:滴定法靶控输注异丙酚,初始血浆浓度0.8g/ml,每5分钟增加浓度0.2g/ml。至OAA/S评分4分时,2利多卡因与1:200000肾上腺素混合液局麻后进行手术。笑气组:滴定法吸入笑气,至OAA/S评分4分时,2利多卡因与1:200000肾上腺素混合液局麻后进行手术。采用Houpt行为治疗效果评分两组患儿术中配合情况,并记录两组患者入室平静后(T0)、输注异丙酚或吸入笑气起效时(T1)、局麻时(T2)、手术开始(T3)、术中(T4)、手术结束时(T5)以及出室时(T6)的心率、血压、血氧饱和度和呼吸频率和NI指数,并记录相关反应情况。结果Houpt3~4分者P组5人,N组4人;Houpt5~6分者P组25人,N组26人。差异均无统计学意义(P>0.05)。T1~5时心率、收缩压、舒张压及NI指数P组明显低于N组(P<0.05);血氧饱和度及呼吸频率两组无明显差异,均在正常范围内。不良反应P组低于N组。结论在小儿埋伏多生牙拔除手术中应用靶控输注异丙酚镇静略优于笑气吸入镇静。
Objective To compare the two methods of sedation and inhalation of propofol in nosocomial implants. Methods Sixty children (aged 6-14 years) with ASA grading undergoing elective anterior extraction were included in this study. Randomly divided into two groups: P group (propofol group, n = 30) and N group (control group, n = 30). Propofol group: Titration target-controlled infusion of propofol, the initial plasma concentration of 0.8g / ml, every 5 minutes to increase the concentration of 0.2g / ml. To OAA / S score 4 points, 2 lidocaine and 1: 200000 epinephrine mixed local anesthesia after surgery. Nitrous oxide group: titration inhalation of nitrous oxide, to OAA / S score 4 points, 2 lidocaine and 1: 200000 epinephrine mixture of local anesthesia after surgery. Houpt behavior was used to evaluate the effect of the two groups of children with intraoperative cooperation, and recorded two groups of patients after birthing (T0), infusion of propofol or inhalation of nitrous oxide (T1), local anesthesia (T2) Heart rate, blood pressure, blood oxygen saturation, respiratory rate and NI index at the beginning of operation (T3), operation (T4), end of operation (T5) Results Houpt3 ~ 4 points in P group 5 people, N group 4; Houpt5 ~ 6 points P group 25 people, N group 26 people. There was no significant difference (P> 0.05). Heart rate, systolic blood pressure, diastolic blood pressure and NI index in group P at T1 ~ 5 were significantly lower than those in group N (P <0.05). There was no significant difference between the two groups in oxygen saturation and respiratory rate, all within the normal range. Adverse reactions P group was lower than N group. Conclusion Target controlled infusion of propofol sedative is superior to nitrous oxide inhalation in infantile ambulatory multiple tooth extraction.