甲状腺次全切除术应用异丙酚与安氟醚进行全麻维持的比较  

comparison of general anesthesia maintained by propofol or enflurane during thyroidectomy

作　　者：郑艳[1] 朱志华[1] 冯微[1] 张禾田[1] 

机构地区：[1]吉林大学中日联谊医院麻醉科,吉林长春130033

出　　处：《中国实验诊断学》2008年第4期498-500,共3页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省卫生厅医学科学基金资助课题(20020673)

摘　　要：目的评价异丙酚静脉麻醉药和安氟醚吸入麻醉药用于全麻术中维持及病人苏醒情况的比较。方法选择肌松要求不高的双侧甲状腺次全切除术病人18例,随机分成异丙酚(P)组和安氟醚(E)组。麻醉诱导后P组用微量泵按4-8 mg/kg.h,同时吸入2∶1的笑气与氧气。E组靠吸入安氟醚0.5-2%合并2∶1的笑气与氧气维持,手术结束停药。术中记录开皮,用药后及术后停药后的血压,心率。并对停药睁眼时间及拔管后苏醒状态进行比较,术后24小时随访,进行统计学分析。结果两组病人一般状况差异无显著性情况下,麻醉维持期间,除异丙酚诱导组在开皮时血压与基础值比较显著降低外,其他各组之间差异无显著性。按照苏醒情况评分表进行评分,同一时间点,P组病人评分高于E组病人。P组病人从停药至睁眼时间均明显短于E组病人,两组间差异显著,术后24 h随访情况,E组病人拔管后再入睡,恶心,呕吐,多痰,躁动发生率大于P组(P<0.01)。结论肌松要求不高的中小型手术用异丙酚进行全麻维持,效果明显优于安氟醚吸入维持麻醉。Objective To compare a kind of intravenous anesthetics-propofol with inhalation anesthetics-enflurane during surgery and recognized the situation during the patients ＇revival.Methods Eghteen thyroidectomic patients were randomly classified into two groups-propofol group and enflurane group.After anesthetic induction P group,using trace pump to keep a speed as 4-8 mg/kg.h and inhale N2O which proportion is 66.7%,with O2.E group patients inspire enflurane concentration 0.5-2% with 66.7% N2O.Stop all the medicine at the end of the surgery.During the surgery,we record the blood pressure and heart rate after induction and after stopping medicine.Also,we take notes of the time of opening eyes.Comparing the recovery situation.In the first 24 hours after surgery,we drop on the patients and record the complications.All the data,we analysis them by statistical method.Results During the surgery,the two groups can all be maintained a satisfactory situation.About blood pressure they have no notable difference except when cutting skin.After operation patients ofP group open the eyes more quickly than E group and get more score than E group.When we drop on the patients in the first 24 hours after surgery,we comprehend that such phenomena as nausea,vomiting,restless and falling asleep after extubation happen more frequently in E group than inP group.Conclusion By compare the two groups we make a result that propofol can offer a more stable surgery course in little muscle relax

关 键 词：全身麻醉 异丙酚 安氟醚 麻醉维持 

分 类 号：R614[医药卫生—麻醉学]