表面麻醉+丙泊酚复合麻醉用于支撑喉镜下声带手术的临床观察

To evaluate the clinical effects of surface anesthesia and intravenous anesthesia in laryngoscopy

目的探讨支撑喉镜下声带手术两种麻醉方法的效果。方法50例行声带手术患者,ASAⅠ—Ⅱ级,随机将病人分为A、B两组,每组25例,A组病人采用咽喉气管内表面麻醉+静脉复合麻醉,B组病人用静脉复合麻醉。观察诱导前、插管后上镜前、上镜后即刻、手术中血压、心率、脉搏氧饱和度变化。结果A组病人上镜即刻血压、心率变化与诱导前,插管后上镜前比较无显著差异(P>0.05);B组病人在上镜即刻血压、心率明显升高,与诱导前、插管后上镜前比较显著性差异(P<0.05);B组病人术后清醒时间比A组延长(P<0.05),有9例出现复睡。结论表面麻醉+丙泊酚复合静脉麻醉,有麻醉手术过程平稳,术后清醒拔管迅速,清醒后无复睡发生的优点,是支撑喉镜下声带手术较为理想的麻醉方法。

Objective To evaluate the clinical effects of two anesthesia methods in laryngoscopy. Methods 50 elderly patients（ASA class 1-2） operated on vocal cords, were nmdondy divided into two greups（.7.5 eases in each）： group A and group B. In group A, patients were anesthesized with surface anesthesia for pharynx and larynx eonbined with intravenous anesthesia. In group B, Patients were anesthesized intravenously. Blood pressure, heart rates and SPO2 were observed before induction, after intubation, and at the time of laryngoscopy. Results The blood pressure and heart rates in group A were smooth and steady during laryngoscopy. The blood pressure and heart rates in group B were significantly higher at the time of laryngoscopy than that before induction and after intubation （P〈0.05）. The time of patients regain consciousness in group B was longer than that in group A （P〈0.05）. Conclusions Surface anesthesia for pharynx and larynx conhined with intravenoas anesthesia is suited for laryngoscopy.