丙泊酚全凭静脉麻醉用于慢性中耳炎手术效果评价  

Application of Total Intravenous Anesthesia in Chronic Otitis Media Surgery

作　　者：张洲[1] 刘奕[1] 

机构地区：[1]重庆市第三人民医院,重庆400014

出　　处：《中国药业》2015年第11期26-28,共3页China Pharmaceuticals

摘　　要：目的探讨丙泊酚全凭静脉麻醉（TIVA）和丙泊酚-七氟烷静吸复合全身麻醉在慢性中耳炎手术中的应用效果。方法将81例慢性中耳炎患者随机分为两组,对照组（51例）采用1%七氟烷吸入麻醉维持,泵注丙泊酚2 mg/（kg·h）,瑞芬太尼（0.1-0.15）μg/（kg·min）,苯磺顺阿曲库铵0.1 mg/（kg·h）;观察组（30例）采用顺阿曲库铵及瑞芬太尼,使用剂量同对照组,但术中仅以丙泊酚5 mg/（kg·h）维持镇静。两组患者麻醉诱导及术中输液量相同,均在Narcotrend麻醉深度监测仪监护下调节镇静深度,其余处理措施也相同。结果两组患者术中生命体征平稳,两组比较无显著性差异（P〉0.05）。对照组患者术后苏醒时间（13.7±4.0）min,呼吸恢复时间（14.7±4.1）min,定向力恢复时间（23.8±5.0）min,拔管时间（18.4±4.8）min,均明显长于观察组的（6.3±2.8）min,（6.5±3.7）min,（12.2±5.0）min,（8.8±5.1）min,组间比较有显著性差异（P〈0.05）。两组患者术后2h内恶心、呕吐发生率比较无显著性差异（P〉0.05）,但对照组烦躁发生率高（P〈0.05）。结论丙泊酚TIVA用于慢性中耳炎手术患者,麻醉效果确切,术中生命体征平稳。与丙泊酚-七氟烷静吸复合全麻比较,术后苏醒更快,呼吸恢复快,气管拔管时间短,术后烦躁几率小,可作为慢性中耳炎患者术中全身麻醉药物。Objective To investigate the application effects of propofol total intravenous anesthesia（TIVA） and propofol-sevoflurane combined intravenous and inhalation general anesthesia in chronic otitis media surgery.Methods 81 cases of chronic otitis media were randomly divided into the two groups.The control group（51 cases） adopted anesthesia maintenance with inhalation of 1% sevoflurane,pumping infusion of propofol 2 mg /（kg·h）,remifentanil（0.1-0.15） μg /（kg·min） and cisatracurium besylate 0.1 mg /（kg·h）; the observation group（30 cases） adopted the same doses of cisatracurium besylate and remifentanil,but only propofol 5 mg /（kg ·h） for maintaining sedation during operation.Both the two groups used the same anesthetic induction and same intraoperative infusion quantity.The sedation depth in the two groups was adjusted under the monitoring of the Narcotrend monitor and the other treatment measures were same too.Results The intraoperative vital signs in the two groups were stable without statistical differences between the two groups（P〉0.05）.The postoperative awakening time,respiratory recovery time,orientation recovery time and extubation time in the control group were（13.7 ± 4.0） min,（14.7 ± 4.1） min,（23.8 ± 5.0） min and（18.4 ± 4.8） min respectively,which were significantly longer than（6.3 ± 2.8） min,（6.5 ± 3.7） min,（12.2 ± 5.0） min and（8.8 ± 5.1） min in the observation group respectively,the differences were statistically significant（P〈0.05）.The incidence rate of nausea and vomiting within postoperative 2h showed no statistically significant difference between the two groups（P〉0.05）,while the control grouphadhigher occurrence rate of postoperative irritability（P〈0.05）.Conclusion TIVA used in the patients with chronic otitis mediahas definite anesthetic effect and stable intraoperative vital signs.Compared with propofol-sevoflurane combined intravenous and inhalation general anesthesia,propofol is more rapid in postoper

关 键 词：丙泊酚 全凭静脉麻醉 静吸复合麻醉 慢性中耳炎 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]