支撑喉镜下喉显微镜手术的麻醉

Anesthesia for Microlaryngoscopic Surgery under Suspension Laryngoscope

目的总结和探讨支撑喉镜下显微喉镜手术的麻醉处理。方法选择近2年我院声带息肉(包括声带囊肿),会厌囊肿患者,共80例,择期行支撑喉镜下喉显微手术,ASAⅠ～Ⅱ级,予以气管内插管,静吸复合麻醉处理。观察围麻醉期生命体征变化、麻醉恢复时间及麻醉期间不良反应。结果全组患者置入喉镜后即刻收缩压(SBP)都有不同程度上升,与诱导前相比差异有显著性(P<0.05)。心率表现为在气管插管后即刻HR上升,P<0.05;而置入喉镜后即刻HR反而下降P<0.05。血氧饱和度(SpO2)在各个时点无明显变化。麻醉期间不良反应均予以妥善处理。结论选择合适的患者及适当的麻醉处理是确保手术成功的关键。

Objective To conclude and discuss the anesthesia for Microlaryngoscopic Surgery under Suspension Laryngoscope. Methods 80 cases of laryngeal disease were observed and operated under mierolaryngoscopy, involving the polyp of the vocal cords, cyst of epiglottis and so on. All patients under Combined Intravenous （or with Inhalation） Anesthesia had an American Society of Anesthesiologists physical status classification of Ⅰ-Ⅱ. Changes of vital signs in peri-anesthesia,recovery time from anesthesia and adverse reactions during the anesthesia were observed and recorded. Results Systolic blood pressure of all patients were increased immediately after implantation laryngoscope. Compared with the pre-induction, there was a significant difference （P〈0.05）. Heart rates were increased immediately after intubation and P〈0.05; but instead decreased immediately after implantation laryngoscope and P〈0.05. There was no significant changes in SpO2 in each time points. All adverse reactions during anesthesis were handled properly. Conclusion Choose the right patients and the appropriate anesthesia treatment is the key to successful surgical treatment.