Observation of Short-Term Sevoflurane Anesthesia for Lumbar Puncture in Children

doi:10.3877/cma.j.issn.1673-5250.2014.06.012

Objective

To observe the effect of short-term sevoflurane anesthesia for lumbar puncture in children.

Methods

From February 2013 to February 2014,113 children who underwent lumbar puncture in Guangzhou Women and Children's Medical Center were included in the study. They were divided into group S (sevoflurane inhaled,n= 58) and group D(diazepam injection,n= 55)according to different ways of sedation. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangzhou Women and Children's Medcial Center. Informed consent was obtained from each participants' parents. No significant difference was found in general clinical data such as age, sex and degree of illness between two groups (P >0.05). The vital signs were observed in both groups. The duration of lumbar puncture, one-time puncture success rate and total success rate of puncture were recorded. The adverse events such as body movement during the operation were also recorded.

Results

① Heart rate at T₂ was obviously higher than that of T₁ in group S(t= - 6.39,P<0.05). Heart rates at T₃ ,T₄ were also higher than T₁ in group D(t = 8.8,6.82 ; P<0.05). There were significant differences in heart rate at T₂ ,T₃ ,T₄ between two groups(t = 4.909,- 13.382,- 12.733; P<0.01) .②Compared with the other observing time, blood oxygen saturation (Spo₂ ) at T₃ was decreased obviously in group D(t= - 7.70,- 7.74, - 7.91; P< 0.05). There was significant difference in Spo₂ at T₃ between two groups(t = 8.141,P<0.01).③No one had body movement during the operation in group S,and 1 case quited the operation(1.7% ). forty cases (72.7%) had body movement during the operation in group D,and 8 cases quited the operation( 14.5% ). ④There were significant differences in one-time puncture success rate and total puncture success rate between two groups (P<0.05).⑤The duration of lumbar puncture in group S was (7.6±2.1) min, which was obviously shorter than (16.0± 8.7) min of group D(P<0.05).⑥ The anesthesia time was (78.3 ± 21.4) s and recovery time was (7.3± 2.1) min in group S.

Conclusions

Short-term sevoflurane anesthesia can improve one-time puncture success rate and shorten the duration of the lumbar puncture. It also can reduce the potential nerve damage.

Key words: Lumbar puncture, Sevoflurane, Child

表1 两组患儿不同观察时刻的HR比较（次/min，±s）

Table 1 Comparison of heart rate changes between two groups at different observation time（次/min，±s）

组别	例数	T₁	T₂	T₃	T₄
S组	58	97.6±10.9	104.1±11.9^a	86.1±7.7	87.4±7.1
D组	55	97.9±14.2	93.7±10.4^a	123.8±19.5	125.9±21.2
t值		-0.135	4.909	-13.382	-12.733
P值		0.893	<0.01	<0.01	<0.01

表1 两组患儿不同观察时刻的HR比较（次/min，±s）

Table 1 Comparison of heart rate changes between two groups at different observation time（次/min，±s）

组别	例数	T₁	T₂	T₃	T₄
S组	58	97.6±10.9	104.1±11.9^a	86.1±7.7	87.4±7.1
D组	55	97.9±14.2	93.7±10.4^a	123.8±19.5	125.9±21.2
t值		-0.135	4.909	-13.382	-12.733
P值		0.893	<0.01	<0.01	<0.01

表2 两组患儿不同观察时刻的Spo₂比较(±s)

Table 2 Comparison of Spo₂ changes between two groups at different observation time(±s)

组别	例数	T₁	T₂	T₃	T₄
S组	58	99.1±0. 8	99.2±1.2	99.4±0.8	99.6±0.6
D组	55	99.3±0.8	99.4±0.8	94.7±4.2	99.3±0.8
t值		-1.178	-1.124	8.141	1.602
P值		0.241	0.264	<0.01	0.112

表2 两组患儿不同观察时刻的Spo₂比较(±s)

Table 2 Comparison of Spo₂ changes between two groups at different observation time(±s)

组别	例数	T₁	T₂	T₃	T₄
S组	58	99.1±0. 8	99.2±1.2	99.4±0.8	99.6±0.6
D组	55	99.3±0.8	99.4±0.8	94.7±4.2	99.3±0.8
t值		-1.178	-1.124	8.141	1.602
P值		0.241	0.264	<0.01	0.112

表3 两组患儿穿刺情况比较[n(%)]

Table 3 Comparison of condition of patients with lumbar puncture between two groups[n(%)]

组别	例数	一次性穿刺成功率	总穿刺成功率	穿刺时间（min, ±s）
S组	58	50(86.2)	58 (98.3)	7.6±2.1
D组	55	36(65.5)	47 (85.5)	16±8.7
_χ²/t值		6.686	6.331	-14.73
P值		<0.05	<0.05	<0.05

表3 两组患儿穿刺情况比较[n(%)]

Table 3 Comparison of condition of patients with lumbar puncture between two groups[n(%)]

组别	例数	一次性穿刺成功率	总穿刺成功率	穿刺时间（min, ±s）
S组	58	50(86.2)	58 (98.3)	7.6±2.1
D组	55	36(65.5)	47 (85.5)	16±8.7
_χ²/t值		6.686	6.331	-14.73
P值		<0.05	<0.05	<0.05

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