Clinical Study on Inhalation Anesthesia with Sevoflurane in Infant Cleft Lip Repair Surgery

Objective To make a comparison between the effect of inhalation anesthesia with sevoflurane and that of intravenous anaesthesia induced with ketamine in infant cleft lip repair surgery,and to assess the clinical value of inhalation anesthesia with sevoflurane in the surgery. Methods Eighty patients with cleft lip and palate,American Society Anesthesiologists(ASA)Ⅰ～Ⅱ,aged 3～10 months,were randomized into two groups(n=40 each) : sevoflurane group and ketamine group.In sevoflurane group,anesthesia was induced with sevoflurane(7%) and oxygen(3 L/min),while in ketamine group,ketamine(2.5 mg/kg) was intravenously injected.After induction,anesthesia of the two groups was maintained by fentanyl(2 μg/kg) and vecuronium(0.1 mg/kg),and their respiration was controlled via anesthesia machine after endotracheal intubation.Sevoflurane group was continuously exposed to 1% ～3% sevoflurane,and ketamine group was administered additional ketamine(1 mg/kg) each time.The two groups were respectively given additional fentanyl(1 μg/kg) for another time during the operation.The induction time and analepsia time were recorded.The mean arterial blood press(MAP),heart rate(HR),oxygen saturation(SpO2) and end-tidal carbon dioxide tension(PetCO2) were measured immediately before and after induction,during operation,before and after endotracheal intubation.The side effects during anesthesia such as irritating cough,holding breathlessness,laryngeal spasm,increased secretion,restlessness or somnolence were noted.Results There were not significant differences in the induction time between the two groups(P0.05),but the analepsia time in sevoflurane group was obviously shorter than that in ketamine group(P0.01).The heart rate and MAP were lower than those in ketamine group(P0.01 respectively),while side effects in sevoflurane group were more severe compared with those in ketamine group(P0.01). Conclusion Inhalation anesthesia with sevoflurane has great advantages over intravenous anaesthesia induced with ketamine in infant cleft lip repair surgery with its rapid induction,shorter analepsia time after operation,and less hemodynamic effects,and with no postoperative restlessness and somnolence observed,and in that it is more safe and controllable in the surgery.