术毕前仅以七氟醚吸入麻醉维持对喉罩通气静-吸复合全麻下行乳腺癌根治术患者PACU停留时间的影响

Effect of anesthesia maintenance by sevoflurane inhalation during the last 30 minutes before the end of radical mastectomy on PACU stay of patients under combined veno-inhalation anesthesia with LMA ventilation

目的观察术毕前仅以七氟醚吸入麻醉维持对喉罩通气静-吸复合全麻下行乳腺癌根治术患者在麻醉后监护室(PACU)停留时间的影响。方法喉罩通气静-吸复合全麻下行乳腺癌根治术患者60例随机分为两组,每组30例。术毕前约30 min,A组停止静脉麻醉用药,仅以七氟醚吸入维持,B组停止七氟醚吸入,持续静脉麻醉用药至手术结束。记录术毕前约30 min内喉罩移位发生率。术毕停止所有麻醉用药,转入PACU复苏。记录患者自主呼吸恢复时间、拔除喉罩时间和PACU停留时间。观察麻醉相关不良反应发生情况。结果与B组比较,A组喉罩移位发生率低(3.3%vs.26.7%)(P<0.05),自主呼吸恢复快,拔除喉罩时间缩短,PACU停留时间减少(P<0.01)。两组麻醉相关并发症发生率相仿(P>0.05)。结论乳腺癌根治术术毕前约30 min仅以七氟醚吸入维持麻醉可以降低患者术中喉罩移位率,缩短患者在PACU的停留时间,且不增加麻醉相关并发症发生率。

Objective To observe the effect of anesthesia maintenance by sevoflurane inhalation during the last 30 minutes before the end of radical mastectomy on post-anesthesia cure unit(PACU)stay of the patients under combined veno-inhalation anesthesia(CVIA)with laryngeal mask airway(LMA).Methods Sixty patients scheduled for radical mastectomy under CVIA were randomly assigned into two groups of A and B with 30 cases each.During the last 30 minutes before the end of surgery,venous anesthetics were stoped and anesthesia was maintained by sevoflurane inhalation until the end of operation in group A,in which sevoflurane inhalation was stoped and anesthesia was maintained by intravenous anesthetics in group B.The incidence of LMA displacement was recorded.The anesthetics in both groups were stoped at the end of operation and the patients were sent to PACU.The times for spontaneous breathing recovery,LMA removal and PACU stay were recorded.The occurrence of anesthesia-related adverse responses was observed.Results Compared with group B,the patients in group A had lower incidence of LMA displacement(3.3%vs.26.7%)(P<0.05),rapid recovery of spontaneous respiration and ealier removal of LMA,and shorter PACU stay(P<0.01).The incidence of anesthesia-related complications of two groups was similar(P>0.05).Conclusion Anesthesia maintenance with sevoflurane inhalation alone during about 30 minutes before the end of operation can reduce LMA displacement rate,shorten PACU stay,and does not increase the incidence of anesthesia-related complications.