摘要
目的探讨七氟烷-雷米芬太尼(瑞芬太尼)复合喉罩通气全身麻醉(全麻)用于经尿道输尿管镜钬激光碎石术(URL)的有效性和安全性。方法将该院2016年1~8月收治的择期行URL的180例输尿管结石患者分为喉罩通气全麻组和腰麻硬膜外联合麻醉(CSEA)组,每组90例。观察围麻醉期各时间点[麻醉前(入手术室后10 min,麻醉未开始)、麻醉后(CSEA组蛛网膜下腔注药后10 min,喉罩通气全麻组静脉诱导后10 min)、术中(手术开始后5 min)及术后(手术结束后5 min)]两组患者血压、心率(HR)、术中不适程度等。结果喉罩通气全麻组患者麻醉后及术中血压、HR无明显变化,CSEA组患者血压明显下降,HR明显增加,差异均有统计学意义(P<0.05);喉罩通气全麻组患者平均动脉压明显高于CSEA组,HR明显低于CSEA组,差异均有统计学意义(P<0.05);喉罩通气全麻组患者无明显体动,因术中无意识,舒适度更高。结论对URL的麻醉,喉罩通气全麻较CSEA更安全、舒适。
Objective To investigate the effectiveness and safety of sevoflurane-remifentanil combined laryngeal mask ventilation general anesthesia used in transurethral ureteroscopic holmium laser lithotripsy（URL）. Methods One hundred and eighty patients undergoing URL from January to August 2016 were divided into the laryngeal mask ventilation general anesthesia group and combined spinal epidural anesthesia （CSEA） group, 90 cases in each group. The blood pressure, heart rate （HR）, dis- comfort degree, etc. at different time points （ 10 rain after entering the operation room, before anesthesia）, after anesthesia （ 10 min after subarachnoid injection in CSEA group, 10 min after intravenous induction in laryngeal mask ventilation general anesthesia group ） , intraoperation （5 rain after operation beginning ） were observed in the two groups. Results The intraoperative blood pressure and HR in the laryngeal mask ventilation general anesthesia group had no obvious changes ,while the blood pressure in the CSEA group was significantly decreased, HR was significantly increased, the differences were statistically significant （P〈0.05） ; the mean arterial pressure in the laryngeal mask ventilation general anesthesia group was significantly higher than that in the CSEA group, while HR was significantly lower than that in the CSEA group, the differences were statistically significant （P〈0.05） ; no obvious body movement occurred in the laryngeal mask ventilation general anesthesia group, and the comfort was higher due to intraoperative unconciousness. Conclusion For URL anesthesia,laryngeal mask ventilation general anesthesia is safer and more comfortable than CSEA.
出处
《现代医药卫生》
2017年第13期1974-1976,共3页
Journal of Modern Medicine & Health
关键词
麻醉
全身
输尿管结石/治疗
输尿管镜检查
碎石术
喉罩
Anesthesia, general
Ureteral calculi/therapy
Ureteroscopy
Lithotripsy
Laryngeal mask
