非气管插管麻醉行声带肿物摘除术的临床探讨

Study of Nontracheal Intubation Anesthesia in Patients Undergoing the Amputation of Glottal Tumor

目的 :探讨非气管内插管麻醉行声带肿物摘除术的可行性。方法 :6 0例声带肿物摘除术的患者随机分三组 ,A组用哌氟合剂作强化麻醉 ,B组单纯用丙泊酚静脉注射 ,C组先静脉注射咪唑安定 0 .1mg/kg ,然后静脉注射丙泊酚。结果 :A、B组置喉镜后MAP、HR较麻醉前改变明显 (P <0 .0 5 )、C组MAP、HR无明显变化 ,组间比较差异显著 (P <0 .0 5 ) ;B、C组苏醒时间无显著性差异 (P >0 .0 5 ) ;A、B组术中有知晓发生 ,C组术中无知晓 ,遗忘作用显著 ,对麻醉满意率比A、B组高。结论 :咪唑安定与丙泊酚联合用药 。

Objective: To observe the feasibility of nontracheal intubation anesthesia in patients undergoing the amputation of glottal tumor.Methods:Sixty patients were randomly divided into three groups. Group A:droperidol dolantin,group B:propofol 2 mg/kg,and group C:midazolam 0.1 mg/kg and propofol 2 mg/kg.No tracheal intubation was operated in the three groups,which were ventilated with high frequency jet ventilation delivery system through direct laryngoscope's aperture.Mean arterial pressure(MAP),heart rate(HR),oxygen saturation (SpO 2) were monitored and recorded before indution,after administration,during laryngoscopy,at 5 min after laryngoscopy,and at 5 min after operation,respectively.Meanwhile,the time of recovery, the adverse reaction of anesthesia was observed.Results:MAP and HR of groups A and B were significantly greater after laryngoscopy than those of preindution( P <0.05),while those of group C were not significantly different. However, both MAP and HR were significatly different among groups A,B,and C( P <0.05).The time of recovery was not significantly different between groups B and C( P >0.05).There had consciousness in groups B and C during operation while no consciousness appeared in group C where there were satisfactory amnesia and anesthesia.Conclusion:It is feasible to operate the total intravenous anesthesia of midazolam combined with proposal during the amputation of glottal tumor.