喉罩置入瑞芬太尼、丙泊酚维持麻醉在择期疤痕切除植皮术中的应用观察  

Observation on the application of remifentanil and propofol in the laryngeal mask to maintain anesthesia in selective scar removal and skin grafting

作　　者：张训功 张金良 孙帅[1] 刘瑶[1] ZHANG Xun-gong;ZHANG Jin-jiang;SUN Shuai;LIU Yao(Department of Anesthesiology,Zhengzhou people's Hospital,Henan Province,450000,China;Department of Anesthesiology,The first people's Hospital of Zhengzhou,Henan Province,450000,China)

机构地区：[1]郑州人民医院麻醉科,河南郑州450000 [2]郑州市第一人民医院麻醉科,河南郑州450000

出　　处：《中国医疗美容》2020年第8期53-57,共5页China Medical Cosmetology

摘　　要：目的观察喉罩置入瑞芬太尼、丙泊酚维持麻醉在择期疤痕切除植皮术中的应用效果。方法选取我院2019年1月~2020年1月间接收的行择期疤痕切除植皮术患者60例作为研究对象,其中依据随机数字表法分成两组,喉罩组(30例)与插管组(30例)。喉罩组接受喉罩置入瑞芬太尼、丙泊酚维持麻醉;插管组行气管插管瑞芬太尼、丙泊酚维持麻醉。对比两组麻醉相关指标(恢复自主呼吸时间、喉罩或者气管导管拔除时间、睁眼时间)、麻醉诱导前(T0)、麻醉诱导后(T1)、置入喉罩或者气管导管1 min(T2)、术毕5 min(T3)、拔除喉罩或者气管导管(T4)血流动力学指标[收缩压(SBP)、舒张压(DBP)、心率(HR)]以及并发症状况。结果与插管组相比较,喉罩组恢复自主呼吸时间、睁眼时间、喉罩或者气管导管拔除时间显著缩短(P<0.05);T1~T4时喉罩组SBP、DBP、HR波动幅度小于插管组(P<0.05);与插管组33.33%(10/30)相比较,喉罩组并发症发生率10.00%(3/30)显著下降(P<0.05)。结论喉罩置入瑞芬太尼、丙泊酚维持麻醉应用于择期疤痕切除植皮术中,可有效改善麻醉效果,维持血流动力学稳定,降低并发症发生风险。Objective To observe the application effect of remifentanil and propofol placed in the laryngeal mask to maintain anesthesia in selective scar resection and skin grafting.Methods Sixty patients with elective scar resection and skin grafting received in our hospital from January 2019 to January 2020 were selected as the research object.According to the random number table method,they were divided into two groups:laryngeal mask group(30 cases)and intubation group(30 cases).In the laryngeal mask group,remifentanil and propofol were inserted into the laryngeal mask to maintain anesthesia;the intubation group received anesthesia with remifentanil and propofol.Comparing the anesthesia-related indicators(recovery time for spontaneous breathing,removal time of laryngeal mask or tracheal tube,and eye opening time),hemodynamic indicators[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)]before anesthesia induction(T0),after anesthesia induction(T1),insertion of laryngeal mask or tracheal tube for 1 min(T2),5 minutes after operation(T3),removal of laryngeal mask or tracheal tube(T4)and complication status of the two groups.Results Compared with the intubation group,the recovery time of spontaneous breathing,eye opening,and the time of laryngeal mask or tracheal tube removal in the laryngeal mask group were significantly shortened(P<0.05);the fluctuation range of SBP,DBP and HR of laryngeal mask group from T1 to T4 was smaller than that of intubation group(P<0.05);compared with 33.33%(10/30)of the intubation group,the incidence of complications in the laryngeal mask group decreased significantly by 10.00%(3/30)(P<0.05).Conclusion The use of remifentanil and propofol in the laryngeal mask to maintain anesthesia for elective scar resection and skin grafting can effectively improve the anesthesia effect,maintain hemodynamic stability,and reduce the risk of complications.

关 键 词：喉罩置入 瑞芬太尼 丙泊酚 维持麻醉 择期疤痕切除植皮术 

分 类 号：R614[医药卫生—麻醉学]