The Clinic Observation Of Anesthesia Induction With Sevoflurane In Infants Undergoing Cleft Lip Repair

Objective:On the basis of the quick and effective pharmacological properties of sevoflurane,the aim of this study was to investigate its security and applicability induction of anesthesia in infants with the cleft lip repair by comparing with propofol and ketamine.Method:90 cases infants with cleft lip including male 48 cases and female 42 cases and aging 3～12 months,62 unilateral and 28 bilateral cases of cleft lip. All infants with ASAⅠ～Ⅱ. grade, body weight> 5 kg, hemoglobin (HGB)> 100g/L, white blood cell count (WBC)<10.0×109/L, no heart and lung, liver and kidney disease and nerve, mental disorders. All infants were randomly divided into 3 group:sevoflurane group (group S,n=30), propofol group(group P,n=30) and ketamine group(group K,n=30). Infants as a routine fasting, forbidden to drink. In order to exclude the effects of atropine on heart rate, all the infants with none of preoperative drug use.Three groups of infants by the anesthesia nurse comes into the operating room, routine ECG monitoring of mean arterial pressure (MAP), heart rate (HR) and peripheral blood oxygen saturation (SPO2). Three groups start every 10 seconds from the induction observed and recorded by the assistant first time and the loss of eyelash reflex response with the disappearance of pain with acupuncture soles of the feet time.Based anesthesia:With sevoflurane (6%)+oxygen (6L/min) mask shut the basis of the appropriate line of pressurized inhalation anesthesia, the pain reflex after vein puncture.The induction of anesthesia:Group S:6%sevoflurane+6L/min O2+Sufentanil 0.3ug/kg +Vecuronim Bromide 0.1mg/kg; Group K:ketamine 2mg/kg+Sufentanil 0.3ug/kg+Vecuronim Bromide 0.1mg/kg; Group P:propofol 3mg/kg+Sufentanil 0.3ug/kg+Vecuronim Bromide 0.1 mg/kg, after the infants induction of anesthesia, we were to complete tracheal intubation in 3 min, carry mechanical ventilation, regulate breathing parameters:Tidal volume 10～15ml/kg; Respiratory frequency 16-24 times/min; Suction ABR1:1.5, and maintain PetCO2 in the normal range.Observe rate in children with loss of consciousness:the time to loss of ciliary reflex, time to loss of pain reflex, limb movement,respiratory secretions, laryngospasm and hemodynamic changes(MAP,HR).Result:During the infants the loss of consciousness of Group S was almost the same with Group:P(P>0.05).The time to loss of ciliary reflex and pain reflex of Group K was significantly longer than Group S and Group P(P<0.05);Group K and Group P easily occured hemodynamic changes, K group of the performance of blood pressure, heart rate, and signs of increased respiratory secretions, laryngospasm such as adverse reactions; P group showed decreased blood pressure, heart rate, limb movement, and so on. Compared with the S group were statistically significant (P<0.05).Conclusion:Sevoflurane anaesthesia produced a good quality of surgical anaesthesia for stable hemodynamic conditions and low respiratory irritations, sevoflurane anaesthesia in infants appears to be an effective and practically useful method of anaesthesia...