摘要
目的观察3种不同药物配伍麻醉对硝酸甘油行控制性降压下眼-鼻内镜手术的影响。方法选择60例择期行眼-鼻内镜微创手术患者,随机分为Ⅰ组(七氟烷吸入麻醉)、Ⅱ组(丙泊酚、瑞芬太尼静脉靶控麻醉)和Ⅲ组(丙泊酚、瑞芬太尼静脉靶控复合七氟烷吸入麻醉)。记录入室时、插管后、手术中、清醒拔管时、拔管后5min的平均动脉压(MAP)、心率(HR),术中硝酸甘油平均均使用量(MN),术后48h内鼻腔出血需内镜下处理人次(CL)。并进行Fromme术野质量评分。结果Ⅰ组清醒拔管时、拔管后5min的MAP、HR均显著高于Ⅱ、Ⅲ组(P<0.01);MN比较为Ⅱ组(0.42±0.04)>Ⅰ组(0.22±0.03)>Ⅲ组(0.09±0.03)mg/(kg·min)(P<0.01);CL患者Ⅲ组(0例)明显少于Ⅰ组(10例)、Ⅱ组(3例)、(P<0.01)。结论丙泊酚、瑞芬太尼静脉靶控复合七氟烷吸入麻醉的效果理想,围术期血液动力学波动平稳,可有效减少各种药物的用量而降低麻醉对手术效果的不良影响。
【Objective】To observe the effect of three kinds of anesthesia with different drugs on the eyeendoscopic surgery under nitroglycerin-controlled hypotension.【Methods】 60 cases of eye-endoscopic surgery were randomly divided into group Ⅰ （sevoflurane inhalation anesthesia）,group Ⅱ （propofol and remifentanil targetcontrolled intravenous anesthesia） and group Ⅲ （propofol,remifentanil target-controlled intravenous combined sevoflurane inhalation anesthesia）.Record mean arterial pressure （MAP） and heart rate （HR） of coming room,after intubation,operating,awake extubation and the extubation after 5 minutes,intraoperative average use of nitroglycerin （MN）,treatment times of nasal cavity bleeding required endoscopic treat within 48 h （CL）.And conduct score of Fromme surgical field quality.【Results】MAP,HR of group Ⅰ patients at awake extubation,the extubation after 5 minutes were significantly higher than which of group Ⅱ,group Ⅲ （P 0.01）;MN of group Ⅲ patients （0.09 ± 0.03） mg /（kg·min） was lesser than that of group Ⅰ （0.22 ± 0.03） mg /kg·min or group II （0.42 ± 0.04） mg/（kg·min） （P 0.01）;CL of group Ⅲ patients （1 case） was lesser than that of group Ⅰ （10 cases）or group Ⅱ （3 cases）,（P 0.01）.【Conclusion】Propofol and remifentanil target-controlled intravenous combined sevoflurane inhalation anesthesia have stabled perioperative hemodynamic fluctuations,can effectively reduce the consumption of various drugs and reduce the adverse effects of anesthesia on the of surgery.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第11期1152-1155,共4页
China Journal of Endoscopy
关键词
硝酸甘油
控制性降压
鼻内镜
全身麻醉
nitroglycerin
controlled hypotension
endoscopic
general anesthesia
