支撑喉镜下喉显微手术麻醉方法比较

The comparison of the anesthetic methods on laryngomicrosurgery under the suspen sion laryngoscopy

目的比较全凭静脉麻醉和静吸复合麻醉在支撑喉镜手术的应用效果。方法选择ASAⅠ-Ⅱ级,拟行支撑喉镜手术的患者37例,随机分成全凭静脉全麻组和静吸复合全麻组。两组诱导方法相同,分别采用异丙酚和异氟醚、笑气吸入维持麻醉,两组均采用氯化琥珀胆碱静脉滴注维持肌松。手术过程中监测收缩压、舒张压、心率、心电图和脉搏血氧饱和度。结果全凭静脉麻醉组血压,心率波动明显,术中呛咳发生率高(P<0.05)。静吸复合麻醉组清醒时间短。结论静脉诱导,吸入维持的复合全麻是支撑喉镜手术较理想的麻醉方法。

OBJECTIVE To compare the effect of different anesthetic methods in o rder to find an ideal anesthetic method for laryngomicrosurgery METHODS Thirty seven ASA Ⅰ-Ⅱadult patients without cardiac diseases undergoing elective susp ension laryngoscopy were randomly divided into two groups. Each group was given different anesthetic method. They were induced with midazolm, propofol, fentanyl and succinylcholine. In group 1,propofol was pumped into vein to sustain anesth esia. Respiration was controlled by jet ventilation with ordinary frequency. Gro up 2 maintained with isoflourane and nitrous oxide and respiration was controlle d by IPPV.Two groups muscle relaxed by succinylcholine.SBP,DBP,HR,ECG and SPO2 were monitored during operation. RESULTS Changes of SBP,DBP,HR and cardiovascul ar response in group 1 were striking and that in group 2 was more smooth. The di fference between group 1 and group 2 were significant(P < 0.05). Patients in gro up 2 had awaked more rapidly than those in group 1. CONCLUSION Intravenous indu ction general anesthesia combined with inhalation maintained was an ideal anesth etic method for laryngeal microsurgery.