丙泊酚或七氟烷维持麻醉对甲状腺切除术患者苏醒质量的影响  

Comparison of the qualities of recovery from anesthesia maintained with propofol or sevoflurane in patients undergoing thyroidectomy

作　　者：朱静[1] 肖成娇 兰晶[3] 刘华跃[2] 金鑫[2] ZHU Jing;XIAO Cheng-jiao;LAN Jing;LIU Hua-yue;JIN Xin(Department of Anesthesiology,Changshu No.1 People′s Hospital,Changshu 215500,Jiangsu,China;Department of Anesthesiology,the First Affiliated Hospital of Soochow University,Suzhou 215031,Jiangsu,China;Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215031,Jiangsu,China)

机构地区：[1]常熟市第一人民医院麻醉科,常熟215500 [2]苏州大学附属第一医院麻醉科,苏州215031 [3]苏州大学附属第一医院普外科,苏州215031

出　　处：《医学研究生学报》2021年第10期1077-1082,共6页Journal of Medical Postgraduates

摘　　要：目的临床实践中,对于丙泊酚或七氟烷的选择可能存在主观偏好。文中比较丙泊酚或七氟烷维持麻醉对甲状腺切除术患者苏醒质量的差异,探讨新鲜气体流量对患者苏醒速度的影响。方法前瞻性纳入2020年12月1日至2021年2月28日期间于苏州大学附属第一医院行甲状腺切除术患者74例,并按照完全随机法分成3组,分别给予持续静脉输注丙泊酚维持麻醉(n=25)、持续吸入七氟烷维持麻醉+术毕低流量新鲜气体(n=25)及持续吸入七氟烷维持麻醉+术毕高流量新鲜气体(n=24)。记录各组患者麻醉苏醒质量,包括其自主呼吸、意识和定向力的恢复时间及术后不良反应情况。结果3组患者从麻醉停药到气管拔管时间分别为(14.1±4.1)、(20.4±5.6)和(14.1±3.6)min,组间差异有统计学意义(P<0.01)。多重比较显示,丙泊酚维持组与七氟烷+高流量气体组患者气管拔管时间差异无统计学意义(P=0.9963);与丙泊酚维持组、七氟烷+高流量气体组比较,七氟烷+低流量气体组患者气管拔管时间延长,差异有统计学意义(P s<0.001)。3组患者术后意识和定向力恢复时间差异表现,与气管拔管时间表现一致。3组患者BIS值上升(60→90)时间分别为(9.8±4.1)、(21.6±6.9)和(13.4±4.9),差异有统计学意义(P<0.01)。3组患者术后不良反应(疼痛、恶心、呕吐和头晕)发生率差异均无统计学意义(P>0.05)。结论丙泊酚或七氟烷维持麻醉对甲状腺切除术患者术毕麻醉苏醒质量并无显著影响。新鲜气体流量高低可决定七氟醚麻醉患者自主呼吸、意识和定向力恢复的快慢。Objective This study was designed to compare the qualities of recovery from anesthesia maintained with propofol or sevoflurane in patients undergoing thyroidectomy,and thus to determine the effect of fresh gas flow on the recovery from anesthesia.Methods Seventy-four patients scheduled for elective thyroidectomy in the First Affiliated Hospital of Soochow University from December 1st,2020 to February 28th,2021 were randomly assigned into three groups.They were arranged to receive either of three treatments:infusion of propofol(Propofol,n=25),inhalation of sevoflurane+low-flow of fresh gas(Sevo-LF,n=25),inhalation of sevoflurane+high-flow of fresh gas(Sevo-HF,n=24).The patients were assessed with several parameters indicating the recovery quality,including the time of recovering spontaneous respiration,the time of retrieving consciousness and orientation,and the occurrence of postoperative adverse reactions.Results The difference between the groups was statistically significant(P<0.01)as the time of extubation were14.1±4.1min(Propofol),20.4±5.6 min(Sevo-LF)and 14.1±3.6 min(Sevo-HF),respectively.There is no significant difference in the time of extubation between Propofol and Sevo-LF(P=0.9963),while the time of extuation in the group of Sevo-LF was significantly longer than that in the groups of Propofol and Sevo-HF(P s<0.001).Meanwhile,the times of retrieving consciousness and orientation were in line with the times of extubation among these groups.The ascending times of BIS value from 60 to 90 were 9.8±4.1 min(Propofol),21.6±6.9 min(Sevo-LF)and 13.4±4.9min(Sevo-HF),with a significant difference of P<0.01.There was no significant difference of adverse reaction among three groups,in terms of pain,nausea,vomiting,or dizziness(P s>0.05).Conclusion The patients anesthetized with either propofol or sevoflurane showed no significant difference of the recovery qualities after elective thyroidectomy.High-flow of fresh gas could greatly accelerate the recovery of spontaneous respiration,consciousness and orientation

关 键 词：丙泊酚 七氟烷 麻醉 苏醒 气管拔管 

分 类 号：R971.2[医药卫生—药品]