摘要
目的比较瑞芬太尼和芬太尼复合丙泊酚全凭静脉麻醉在支撑喉镜下声带息肉摘除术中的临床应用效果与价值。方法选择ASAⅠ-Ⅱ级择期行支撑喉镜下声带息肉摘除术患者60例,随机分为瑞芬太尼组(观察组)和芬太尼组(对照组),每组各30例。记录患者诱导前(T0)、诱导后(T1)、插管时(T2)、置入支撑喉镜时(T3)、摘除声带息肉时(T4)、拔管时(T5)6个时间点的平均动脉压(MAP)和心率(HR),记录患者自主呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间、离开手术室时间。结果麻醉手术期间,与对照组比较:在T0、T1的MAP、HR无明显变化(P>0.05),在T2、T3、T4、T5的MAP、HR变化显著(P<0.05);与T0比较:T1时两组的MAP、HR均明显降低(P<0.05),观察组在T2、T3、T4、T5的MAP、HR无明显变化(P>0.05),对照组在T2、T3、T4、T5的MAP、HR均明显升高(P<0.05)。术后自主呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间、离开手术室时间观察组明显低于对照组(P<0.05)。结论瑞芬太尼复合丙泊酚全凭静脉麻醉具有诱导平稳、术中血流动力学稳定、心血管反应轻、术后苏醒快等优点,临床应用于支撑喉镜下声带息肉摘除术比芬太尼复合丙泊酚麻醉更具有优越性。
Objective To comparie clinical effect of remifentanil and fentanyl and propofol on TIVA suspension laryngoscopy in vocal cord polyps surgery.Methods 60 patients with ASA I-II class elective suspension laryngoscopy on vocal cord polyp removal surgery were randomly divided into the remifentanil group（study group） and fentanyl（control group）,30 cases in each group.The arterial pressure（MAP） and heart rate（HR） before induction（T0） and after induction（T1）,intubation（T2）,when placed in suspension laryngoscopy（T3）,removal of the polyp of vocal cord（T4） and extubation（T5） were recorded.The spontaneous breathing,eye opening,extubation,orientation recovery time and leaving the operating room time were observed.Results The MAP and HR of study group at T0 and T1 were not different from that on control group（P〈0.05）.The MAP and HR of study group at T2,T3,T4 and T5 were different from that on control group（0.05）.Spontaneous breathing after surgery recovery time,opening eyes,extubation,orientation recovery time,leave the operating room time of study group were significantly lower than the control group（P〈0.05）.Conclusion Remifentanil and propofol phenol TIVA induce stable,hemodynamic stability,intraoperative cardiovascular responses to light,and postoperative recovery advantages of rapid clinical application of suspension laryngoscopy vocal cord polyp excision Biffen fentanyl and propofol anesthesia has more advantages.
出处
《西部医学》
2012年第10期1924-1925,1928,共3页
Medical Journal of West China
