不同给药模式下支撑喉镜声带手术的麻醉比较  

Different dosing mode the laryngoscope vocal cords surgery anesthesia

作　　者：陈书萍[1] 程豪[1] 徐茜[1] Chen Shu-ping;Cheng Hao;Xu Qian(Department of Anesthesia, Guanghan, Sichuan Province People's Hospital, Guanghan, Sichuan, 618300, China)

机构地区：[1]四川省广汉市人民医院麻醉科,四川广汉618300

出　　处：《当代医学》2017年第13期15-17,共3页Contemporary Medicine

摘　　要：目的探讨术中是否运用非去极化肌松药两种不同给药模式下支撑喉镜声带手术的麻醉效果与安全性。方法择期拟行支撑喉镜下声带手术的患者60例,ASAⅠ或Ⅱ级,随机均分为小剂量维库溴胺组(V组)和对照生理盐水组(N组),每组30例。V组为麻醉诱导插管后,给予维库溴胺0.03 mg/kg,N组给予0.9%氯化钠溶液2 m L,余两组麻醉处理方式相同。记录两组麻醉诱导前(T0)、支撑喉镜置入即刻(T1)的MAP和HR。同时记录两组丙泊酚用量、麻醉时间、手术时间、置入支撑喉镜时是否有阻力、阻力的大小以及麻醉苏醒情况和不良反应。结果与T0时比较,T1时两组均MAP明显升高,HR明显增快,差异有统计学意义(P<0.05);而两组间血流动力学指标差异无统计学意义。与N组比较,V组丙泊酚总用量明显减少,放支撑喉镜时有阻力及阻力大的例数明显减少,差异有统计学意义(P<0.05)。N组术毕自主呼吸恢复时间、呼之睁眼时间、拔管时间较V组明显延长(P<0.05)。结论支撑喉镜声带手术中给予小剂量非去极化肌松药,更有利于短时支撑喉镜声带手术的全麻维持和术者操作,缩短患者术后苏醒时间。Objective To investigate whether intraoperative use of non depolarizing muscle relaxant to release it two different type support laryngoscope under the anesthetic effect and security of the vocal cords surgery.Methods Marked line fitting the laryngoscope under60patients with vocal cord surgery,ASA gradeⅠorⅡ,randomLy were divided into small dose of vecuronium bromide group group(V)and contrast the physiologicalsaline group(N group),30cases in each group.V group after induction of anesthesia intubation,give vecuronium bromide amine0.03mg/kg,N were given saline2mL,more than two sets of anesthesia to deal with the same way.Records of the two groups before anesthesia induction(T0),the laryngoscope in immediate(T1)MAP and HR.Record at the same time two groups of dosage of propofol anesthesia time,operation time,ifthere is a resistance when placing the laryngoscope,the size of the resistance and awaken anesthesia and adverse reactions.Results Both groupswhen compared with the T0,T1MAP elevated obviously,HR significantly faster(P<0.05).And there was no statistically significant difference hemodynamicparameters between two groups.Compared with N group,the total dosage of propofol V group was obviously reduced,put the laryngoscoperesistance and resistance of the samples decreased significantly(P<0.05).N group a spontaneous breathing recovery time,called the opentime,extubation time significantly longer in the V group(P<0.05).Conclusion Support laryngoscope vocal cords surgery in small doses of nondepolarizing muscle relaxant,more conducive to short-term support laryngoscope vocal cord surgery maintain and performer during anesthesia operation,shortening patients postoperative waking time.

关 键 词：不同给药模式 小剂量非去极化肌松药 支撑喉镜声带手术 麻醉比较 

分 类 号：R614[医药卫生—麻醉学]