外耳再造手术全麻苏醒期躁动回顾性分析  

General anesthesia on the incidence of EA in operation of auricular reconstruction was retrospectively analyzed

作　　者：董龙禹[1] 苏法仁[1] 王云[1] 窦林彬[1] 李江伟[1] 郭玉洁[1] 吴明毅[1] 

机构地区：[1]武警山东总队医院麻醉科,山东济南250014

出　　处：《武警后勤学院学报（医学版）》2014年第4期303-305,共3页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】比较外耳再造手术中4种麻醉方法对全麻苏醒期躁动（emergence agitation，EA）发生率的影响。【方法】2002年6月-2013年8月，外耳再造手术860例，分别采用吸入异氟醚53例（Ⅰ组），吸入七氟醚88例（Ⅱ组），吸入七氟醚与静脉复合麻醉152例（Ⅲ组），全凭静脉麻醉567例（Ⅳ组）。所有患者麻醉诱导均采用丙泊酚2．5mg／kg，维库溴铵0．1mg／kg，芬太尼2μg／kg。I组术中维持吸入1％～2％异氟醚；Ⅱ组术中维持吸入3％～5％七氟醚；Ⅲ组静脉泵注内泊酚50～70μg·（kg·min）^-1，瑞芬太尼0．2μg·（kg·min）^-1，吸入1％～3％七氟醚，以上3组皆每间隔40min静注维库溴铵0．05mg／kg维持肌松。Ⅳ组采用无使用肌松药物，全凭静脉麻醉维持，静脉泵注丙泊酚45～50μg·（kg·min）^-1，瑞芬太尼03～0．5μg·（kg·min）^-1。苏醒期观察各组EA发生例数，统计EA持续时间。【结果】Ⅳ组EA发生率最低，持续时间最短，与其余3组比较有非常显著差异。【结论】无使用肌松药物麻醉维持，丙泊酚一瑞芬太尼全凭静脉麻醉，EA发生率低，持续时间短，适用于外耳再造手术的麻醉。[ Objective ]To compare the effect of four kinds general anesthesia methods on the incidence of emergence agitation （EA） in operation of auricular reconstruction. [ Methods ] 860 auricular reconstruction patients （7- 25 years old; 503male and 357 female） were divided into four groups undergoing general anesthesia, and anesthesia induction of all the patients was intravenously injected with propofol 2.5 mg/kg, vecuronium 0.1 mg/kg, fentanyl 2μg/kg. After induction of anesthesia, group I was handled with 1% ~2% isoflurance inhalation anesthesia, group Ⅱ with 3%-5% sevoflurane inhalation anesthesia, group Ⅲ with continuous intravenous infusion propofol 50 - 70μg＂ ·（kg· min）^-1, remifentanyl 0.2 μg· （kg·min）^-1, and inhalation 1% - 3% sevoflurane, while group IV was dealt with total intravenous anesthesia （TIVA）, anesthesia was maintained with propofol 45 - 50（kg· min）^-1 remifentanyl 0.3 - 0.5 （kg·min）^-1, and without muscle relaxants. In groups Ⅰ, Ⅱ and Ⅲ, intermittent intravenous vecuronium was used to maintain proper muscle relaxation; At general anesthesia emergence duration, the EA occurrence rate and EA persistence time are observed. [ Results] EA occurrence rate was the lowest and EA persistence time was the shortest in group IV, and there was a significant difference compared with other three groups （P 〈 0.01）. [Conclusion ] There was no use of muscle relaxants in group Ⅳ（TIVA）, so the EA occurrence rate was lower and EA persistence time was shorter, which was suitable in auricular reconstruction operation.

关 键 词：外耳再造 麻醉 躁动 

分 类 号：R614.2[医药卫生—麻醉学]