Objective To observe the effect of sevoflurane inhalation via the combined
inhalation anesthesia induction device (CIAI) in emergency manual reduction of
humeral supracondylar fracture in children.
Methods This was a control trial. Eighty-one children with humeral supracondylar
fracture took manual reduction in Emergency Department, Hospital of 73th Army
Group of Land Force from July 2015 to May 2020,including 42 males and 39
females, and they were 2 to 5 (3.24±1.71) years old. The patients were divided
into a CIAI Group (42 cases) and a control group (39 cases). Before the manual
reduction, the CIAI group were given sevoflurane 2-5 ml/time by the combined
inhalation anesthesia induction device, while the control group were given
propofol 3-4 mg/kg intravenously. Before (T1) and during (T2) the manual
reduction and when the children came to (T3), the heart rates, oxygen
saturations (SpO
2), mean arterial pressures (MAP), Ramsay Sedation
scores, The Face, Legs, Activity, Cry, Consolability Behavioral Tool (FLACC)
scores, frequencies of adding drugs, and incidences of adverse reactions were
statistically analyzed. The Shapiro-Wiktest test was used to evaluate the
normality of the measurement data. The measurement data of normal distribution
were expressed as (
x±s
), and were compared between the two groups by independent-sample
t test.
Results At T1, there were no statistical differences in
MAP, HR, and SpO
2 between the two groups (all
P>0.05). The MAP, HR, and SpO
2 at T2 and T3 were (69.9±5.1) mmHg (1 mmHg=0.133 kPa) and (69.1±4.1) mmHg,
(109.5±8.1) beats/min and (103.9±6.3) beats/min, and (98.9±0.7) mmHg and
(98.9±0.8) mmHg in the control group, and were (69.1±5.8) mmHg and (69.5±5.1)
mmHg, (93.6±2.9) beats/min and
(95.6±5.6) beats/min, and (99.3±0.6)
mmHg and (99.5±0.5) mmHg in the CIAI group, with lower fluctuations in the CIAI
group (all
P<0.05). There were no
statistical differences in the Ramsay and FLACC scores between the two groups
before and after the manual reduction (all
P>0.05).
The CIAI group fell asleep slower and recovered faster than the control group
[(38.2±10.3) s vs. (24.2±4.5) s and (5.8±1.9) min vs. (20.1±4.5) min; both
P<0.05]. The incidences of
restlessness and increased oral secretion and the total incidence of adverse
reactions in the CIAI group were lower than those in the control group (all
P<0.05).
Conclusion Compared with the traditional intravenous administration of propofol,
the inhalation of sevoflurane by the combined inhalation anesthesia induction
device in children with humeral supracondylar fracture in the operation room
has ideal clinical outcomes. It is more humanized in the application process,
with ideal safety, more convenience, high comfort, low cost, and fewer adverse
reactions. Therefore, it is suitable for further clinical application and
promotion.
