表面麻醉联合静脉浅全麻在支撑喉镜声带手术中的应用  

Application of combined surface anesthesia and light total intravenous anesthesia during vocal cord surgery under the suspension laryngoscope

作　　者：李振华 王田琪 李国宏 蔡宏伟[2] 

机构地区：[1]深圳市公明人民医院麻醉科,广东深圳518106 [2]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《现代医药卫生》2008年第21期3199-3200,共2页Journal of Modern Medicine & Health

摘　　要：目的:观察表面麻醉加静脉浅全麻在支撑喉镜手术中的效果。方法:择期ASAⅠ级声带息肉或小结摘除术60例,随机分成全麻组和表面麻醉联合静脉浅全麻组,每组30例。比较两组术中血流动力学变化和呼吸恢复时间、拔管时间以及手术条件评分。结果:全麻组的收缩压(SBP)和心率(HR)在插管后、支撑喉镜置入后以及拔管后均分别较插管前、支撑喉镜置入前以及拔管前明显升高(P<0.01);在插管后、支撑喉镜置入后和拔管后3个时间点,全麻组的SBP和HR显著高于联合组(P<0.05);联合组的呼吸恢复时间和拔管时间明显短于全麻组(P<0.01)。结论:表面麻醉联合静脉浅全麻能够获得较好手术条件,具有良好的咽喉反射抑制作用,平稳的血流动力学,苏醒拔管快等优点。Objective：To observe the effect of surface anesthesia combined with light total intravenous anesthesia during vocal cord surgery under the suspension laryngoscope.Methods：Sixty ASA 1 patients scheduled for elective vocal cord surgery were included in this study, and were randomly divided into two groups：general anesthesia group（group A, n=30） and combined surface anesthesia and light total intravenous anesthesia group（Group B, n=30）.hemodynamics was compared at before intubation（T0）, after intubation（T1）, before suspension laryngoscopy posting（T2）,after suspension laryngoscopy posting（T3）,before extubation（T4） and after extubation（TS）,operation condition score,respiration comeback time and extubation time were also compared in two groups.Results：In group A,SBP and HR of at T1, T3,T5 were significantly higher than those of at T0,T2,T4 respectively （P〈0.01） ,compared with group B,SBP and HR of group A were significantly higher at T1 ,T3 and TS（P〈0.05） ;respiration comeback time and extubation time of group B were shorter than those of group A （P〈0.01）.Conclusion：Surface anesthesia combined with light total intravenous anesthesia can obtain good operation conditions,which has stable hemodynamics and faster extubation advantages,it is a ideal anesthetic method for vocal cord surgery under the suspension laryngoscope.

关 键 词：麻醉 表面 静脉 喉镜检查 手术 声带 

分 类 号：R614[医药卫生—麻醉学]