局部麻醉下控制性低血压在鼻内镜手术中的应用

The value of induced hypotension in nasal endoscopic surgery

目的:探讨局部麻醉下控制性降压在功能性鼻内镜手术中的应用价值。方法:将鼻内镜手术患者随机分为控制性降血压组和对照组。记录2组术前、降压前、手术30 min时及术毕时的平均动脉压(MAP)、心率(HR)、血氧饱和度(SaO2)及血气值、出血量、术野评级、手术时间。结果:手术30 min时2组HR较术前均有明显增快(P<0.01),SaO2较术前有显著下降(P<0.01)。2组术毕时MAP、HR、SaO2和血气值差异无统计学意义(均P>0.05)。2组出血量、手术时间、术野清晰度评分比较差异均有统计学意义(均P<0.05)。结论:局部麻醉下控制性降压可减少功能性鼻内镜手术的出血量,保持术野清晰,缩短手术时间,具有较高的安全性及临床使用价值。

Objective：To observe the value of induced hypotension in nasal endoscopic surgery with local anesthesia. Method： Sixty Patients were randomly divided into two groups. Group Ⅰ ： induced hypotension group; Group Ⅱ ： control group. MAP, HR, SaO2 amount of blood loss, clear visual field of operation and the operation time were observed and compared between two groups. Result： The difference of MAP, HR, SaO2 data between two groups showed no statistic difference with anatomiacal measurement（ P 〉0.05）. The difference of amount of blood loss, the operation time and clear visual field of operation between two groups was significant（ P 〈0.05）. Conclusion,The induced hypotension with localanesthesia can produce time of operation and amount of blood loss decreased. It can safely applied to the in clinical practice.