微量输液泵控制麻醉在腹腔镜妇科手术中的临床观察

Clinical application of microdosage pump anesthesia in gynecologic laparoscopic operation patients

目的研究静脉微量泵麻醉、静吸复合麻醉和单纯静脉麻醉对患者气管插管及苏醒期血流动力学变化和拔管条件的影响。方法美国麻醉学会手术前分级标准原则(ASA)Ⅰ～Ⅱ级择期妇科腹腔镜手术的病人180例,随机分为微量泵麻醉组(Ⅰ组)、静吸复合麻醉组(Ⅱ组)和单纯静脉麻醉组(Ⅲ组),每组60例。记录术毕停药后病人清醒时间、拔管时间,记录病人拔管后即刻、离开手术间。观察恶心、呕吐等副作用。结果麻醉诱导后气管插管1～5min内血流动力学变化幅度Ⅰ组明显小于Ⅱ、Ⅲ组(P<0.05);术后清醒时间及拔管时间Ⅰ组早于Ⅱ、Ⅲ组(P<0.05),并且恶心、呕吐发生率低。结论微量泵静脉控制麻醉在气管插管和麻醉苏醒期的血流动力学稳定,拔管条件优,并发症少。

Objective To study the differences between microdosage pump, propofol plus inhalational isoflurane and simple intravenous anesthesia in the hemodynamic changes during intratracheal intubation and recovery of consciousness in general anesthesia and to explore the options of extubation. Methods One hundred and eighty gynecologic laparoscopic operation patients （ASA Ⅰ～Ⅱ） were randomly divided into micredosage pump group （group Ⅰ ）, propofol plus inhalational isoflurane group （ group Ⅱ） and simple intravenous anesthesia group （ group Ⅲ）, with 60 for each. The time of eye opening and extubation following anesthetic discontinuation was recorded after extubation and leaving of the operation room. The side effects of anesthetics such as nausea and vomiting were recorded. Results Hemodynumie changes within 1 - 5 minutes after the induction of anesthesia and intubation in group Ⅰ were significantly less than those in group Ⅱ , and group Ⅲ （ P 〈 0.05 ）. The recovery time from anesthesia was shorter and the intratraeheal tube could be removed earlier in group Ⅰ（ P 〈0.05 ）. Less nausea or vomiting occurred in group I than that in group Ⅱ and group m. Condusion Anesthesia with microdosage pump shows stable hemodynumies and less complications during intratracheal intubation and can shorten the recovery time of unconsciousness and the duration of intubation.