七氟醚吸入在老年患者非插管胸腔镜肺叶楔形切除术中的应用  

Application of sevoflurane inhalation maintenance in management of nonintubated thoracoscopic pulmonary wedge resection for the elderly

作　　者：朱斌斌[1] 吴祥[1] 高彬[1] 周成伟[1] 赵伟军[1] 万红梅 桂煜[1] ZHU Binbin;WU Xiang;GAO Bin;ZHOU Chengwei;ZHAO Weijun;WAN Hongmei;GUI Yu(Department of Anesthesia,the Affiliated Hospital of Medical school,Ningbo University,Ningbo 315000,China)

机构地区：[1]宁波大学医学院附属医院麻醉科,315000

出　　处：《临床麻醉学杂志》2018年第12期1176-1179,共4页Journal of Clinical Anesthesiology

基　　金：宁波市自然科学基金(2017A610220)

摘　　要：目的评估七氟醚吸入麻醉在老年患者非插管胸腔镜肺叶楔形切除术中的效果及术后早期恢复质量。方法选择择期非插管胸腔镜肺楔形切除老年患者38例,男17例,女21例,年龄65～85岁,ASAⅠ或Ⅱ级。采用随机数字表法分为两组:丙泊酚静脉麻醉组(P组)和七氟醚吸入麻醉组(S组),每组19例。两组均在胸段硬膜外麻醉后静脉诱导置入喉罩行保留自主呼吸。记录楔形切除即刻呼吸频率;记录患者苏醒时间、拔喉罩时间、出手术室时间,术毕下床活动时间,进食时间和出院时间;记录麻黄碱追加例数和机械通气例数;记录患者术后头晕、恶心、呕吐、躁动等不良反应的发生情况。结果与P组比较,S组肺叶切除即刻呼吸频率明显减慢,麻黄碱追加例数和机械通气例数明显减少,停药后苏醒时间、拔喉罩时间和术后下床活动时间明显缩短(P<0.05)。两组术中呛咳发生例数差异无统计学意义。两组术后并发症发生率及进食时间、出院时间差异无统计学意义。结论非插管胸腔镜肺叶楔形切除术采用七氟醚吸入麻醉有利于老年患者快速康复。Objective To evaluate the advantages of sevoflurane maintenance in nonintubated thoracosopic pulmonary wedge resection for the elderly patients.Methods Thirty-eight patients,17 males and 21 females,aged 65-85 years,ASA physical statusⅠorⅡ,scheduled to undergo nonintubated thoracosopic pulmonary wedge resection,were randomly allocated to two groups(n = 19):propofol maintenance group(group P)and sevoflurane maintenance group(group S).Laryngeal mask(LMA)and spontanous ventilation were successively applied after thoracic epidural anesthesia.RR at the completion of wedge resection was recorded,time of emergence from general anesthesia,leaving recovery room,the first ambulation,the first food intake and discharge were recorded,ephedrine administration and mechanical ventilation were noted and adverse events including dizziness,nausea and vomiting,emergence agitation were evaluated.Results Compared with group P,respiratory rate at the moment of resection declined.The duration of emergence time,extubation of LMA,leave recovery room and ambulation were shortened while no differences were seen on the time of first food intake and discharge,the times of ephedrine given and mechanical ventilation were decreased in group S.There were no statistical differences of incidence of adverse events between the two groups.Conclusion Sevoflurane-maintained anesthesia in nonintubated-thoracosopic pulmonary wedge resection facilitates rapid recovery in elderly patients.

关 键 词：七氟醚 丙泊酚 非插管胸腔镜 肺叶楔形切除术 老年 

分 类 号：R614[医药卫生—麻醉学]