引用本文:解 冉,王 皓,纪凡层,岳天强.快通道麻醉在支撑喉镜下声带息肉摘除术中的效果观察[J].中国临床新医学,2019,12(5):536-539.
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快通道麻醉在支撑喉镜下声带息肉摘除术中的效果观察
解 冉,王 皓,纪凡层,岳天强
261000 山东,潍坊医学院麻醉学系(解 冉);272500 山东,汶上县人民医院康复科(王 皓);261000 山东,潍坊市人民医院麻醉科(纪凡层);261000 山东,维坊市昌乐县中医院麻醉科(岳天强)
摘要:
[摘要] 目的 观察靶控输注丙泊酚瑞芬太尼复合米库氯铵的快通道麻醉在支撑喉镜手术中的临床应用效果。方法 选择成人择期声带息肉摘除手术患者60例,ASAⅠ~Ⅱ级,随机分为观察组和对照组,各30例。观察组采用靶控输注丙泊酚瑞芬太尼复合米库氯铵全凭静脉麻醉。对照组采用丙泊酚舒芬太尼复合罗库溴铵麻醉。监测两组麻醉前(T0)、插管前(T1)、插管固定后(T2)、支撑喉镜放置后(T3)、撤除喉镜后(T4)、出麻醉恢复室(PACU)(T5)的平均动脉压(MAP)、心率(HR),记录手术时间、麻醉时间、拔管时间、PACU观察时间、PACU内Riker镇静躁动评分。结果 与同组T0相比,T1、T2的MAP、HR均明显下降(P<0.05);与同组T1、T2、T4相比,T3的MAP、HR显著升高(P<0.05)。不同时点MAP、HR水平两组比较差异无统计学意义(P>0.05)。观察组的拔管时间与PACU观察时间均早于对照组(P<0.05)。两组麻醉时间与手术时间比较差异无统计学意义(P>0.05)。结论 丙泊酚瑞芬太尼靶控输注复合米库氯铵的快通道麻醉用于支撑喉镜下声带息肉摘除术时血流动力学相对稳定,患者术后苏醒较为迅速。
关键词:  快通道麻醉  丙泊酚  瑞芬太尼  米库氯铵  支撑喉镜
DOI:10.3969/j.issn.1674-3806.2019.05.17
分类号:R 762
基金项目:
Evaluation of the effect of fast-tracking anesthesia on excision of vocal cord polyps by suspension laryngoscope
XIE Ran, WANG Hao, JI Fan-ceng, et al.
Department of Anesthesiology, Weifang Medical University, Shandong 261000, China
Abstract:
[Abstract] Objective To observe the clinical effect of intravenous fast- tracking anesthesia using target-controlled infusion(TCI) with propofol and remifentanil combined with mivacurium on patients undergoing suspension laryngoscope surgery. Methods Sixty adult patients(ASAⅠ~Ⅱ) were performed selective polypectomy of vocal cords and were randomly divided into observation group and control group, with 30 cases in each group. The patients in the observation group were anesthetized with target-controlled intravenous infusion of propofol, remifentanil and mivacurium, and the patients in the control group were anesthetized with propofol, sufentanil and rocuronium. The mean arterial pressure(MAP), heart rate (HR), operation time, anesthesia time, extubation time, residence time in PACU and Riker sedation-agitation scale scores in PACU were monitored in both of the two groups before anesthesia(T0) and intubation(T1), and after endotracheal intubation(T2) and placement of suspension laryngoscopy(T3) and removal of laryngoscope(T4) and leaving PACU(T5). Results Compared with those of T0 in the same group, the MAP and HR of T1 and T2 were significantly decreased(P<0.05). Compared with those of T1, T2 and T4 in the same group, the MAP and HR of T3 were significantly elevated(P<0.05). There were no statistically significant differences in the levels of MAP and HR between the two groups at different time points(P>0.05). The extubation time and residence time in PACU of the observation group were significantly earlier than those of the control group(P<0.05). There were no statistically significant differences in the anesthesia time and the operation time between the two groups(P>0.05). Conclusion Fast-tracking anesthesia of target-controlled infusion with propofol, remifentanil and mivacurium can maintain relatively hemodynamic stability and shorten the postoperative awakening period in the patients undergoing polypectomy of vocal cords by suspension laryngoscope.
Key words:  Fast-tracking anesthesia  Propofol  Remifentanil  Mivacurium  Suspension laryngoscope