不同麻醉方法对支撑喉镜声带手术应激反应的影响  

Effect of different anesthetic techniques on the stress response in self-retaining laryngoscope of vocal cords surgery

作　　者：秦旭[1] 

机构地区：[1]凉山州第一人民医院麻醉科,四川西昌615000

出　　处：《西部医学》2009年第2期266-267,共2页Medical Journal of West China

摘　　要：目的观察和比较全凭静脉麻醉和静吸复合麻醉对支撑喉镜声带手术应激反应的影响。方法将60例择期行声带手术患者随机分为2组:全凭静脉麻醉组(A组)和静吸复合麻醉组(B组),每组各30例。麻醉维持:A组以异丙酚、瑞芬太尼和司可林维持;B组以芬太尼、异氟醚和司可林维持。观察记录麻醉前、后,气管插管和置入支撑喉镜后1、5min及术毕10 min的血流动力学变化,同时观察麻醉苏醒及不良反应等情况。结果两组诱导后平均动脉压和心率均较诱导前下降(P<0.05)。气管插管1 min和5 min时A组血流动力学变化幅度明显小于B组(P<0.05),且A组自主呼吸恢复时间、呼之睁眼时间、拨管时间明显短于B组(P<0.05)。结论全凭静脉麻醉维持,可以有效抑制气管插管和置入支撑喉镜引起的应激反应,苏醒迅速,在支撑喉镜下声带手术麻醉方法中,明显优于静吸复合麻醉。Objective To compare the effect of total intravenous anesthesia（TIA）and combined inhalation and intravenous anesthesia（CⅡA）on the stress response in self-retaining laryngoscope of vocal cords surgery. Methods 60 patients scheduled for surgery through suspension laryngoscopy were randomly divided into the group A and groupB. During maintenance of anesthesia, propofol, remifentanil and scopolamine were used in group A, whereas fentanyl, scopolamine and isoflurane were used in group B. The indexes of haemodynamics were measured in patients before anesthesia, during and 10 min after surgery. The recovery time of anesthesia and adverse reactions were observed. Results Hemodynamic changes during in group A intubation were significantly fewer than that in group B（P〈0.05）. The time to opening eyes on command and recovery from anesthesia in group A were shorter than that in group B（P〈0.05）. Conclusion TIA could attenuate the stress response to self-retaining laryngoscope of vocal cords surgery, which is safe and effective.

关 键 词：麻醉方法 支撑喉镜 声带手术 应激反应 

分 类 号：R614.2[医药卫生—麻醉学] R767.91[医药卫生—外科学]