瑞芬太尼复合丙泊酚静脉全麻用于声带息肉摘除术的临床观察

Observation of General Anesthesia with Infusion of Remifentanil-propoful in Vocal Cord Polyp Extirpation

目的探讨瑞芬太尼复合丙泊酚静脉全麻用于声带息肉摘除术的临床应用价值。方法选择ASAⅠ～Ⅱ级,择期行声带息肉手术患者60例,随机分为瑞芬太尼复合丙泊酚组(R组,n=30)和芬太尼组(F组,n=30),R组采用咪达唑仑-维库溴铵-瑞芬太尼-丙泊酚诱导和维持麻醉,F组采用咪达唑仑-维库溴铵-芬太尼-丙泊酚诱导和异氟醚吸入维持麻醉,观察2组麻醉诱导和维持期血流动力学变化,术毕停药后患者自主呼吸恢复时间、呼之睁眼时间、拔管时间、定向力恢复时间和离开恢复室时间。结果R组麻醉中循环波动小,患者自主呼吸恢复时间、呼之睁眼时间、拔管时间和离开恢复室时间较F组快。结论瑞芬太尼复合丙泊酚全麻可安全有效地用于声带息肉手术,有较高的临床价值。

Objective To study the safe and effective anesthesia methods in polyp of vocal cord extirpation. Methods Total 60 patients （ASA Ⅰ - Ⅱ ） undergoing vocal cord polyp extirpation were randomly divided into two groups （n = 30）. Remifentanil group were given anesthetic induction and maintenance with midazolam -vecuronium -remifentanil -propofol;while Group F enfanil were given anesthetic induction with midazolam - vecuronium - fentanil - propofol and maintenance with isoflurance. The hemodynamics during induction of anesthesia and maintenance anesthesia, and time for stoping administration of anesthethetic untill full spontaneous respiration, eye opening, tracheal extubation,orientation and discharging from the postanesthetic care unit （PACU） were compared. Results Anesthesia by remifentanil produces less circulatory fluctuation, and less time for full spontaneous respiration, eye opening, tracheal extubation, orientation and discharging from the PACU than group F. Conclusion Anesthesia with midazolam- vecuronium -remifentanil- propofol can be used safely and effectively in vocal cord polyp extirpation.