七氟烷吸入麻醉复合艾司洛尔在声带息肉摘除术中的应用

Effect of sevoflurane inhalation in combination with esmolol in excision of vocal cord polyp

目的探讨吸入七氟烷麻醉复合艾司洛尔在声带息肉摘除术中的效果。方法选择患者60例,随机分为Ⅰ组(艾司洛尔组)与Ⅱ组(对照组),每组各30例。Ⅰ组在气管插管前2m in静脉注射艾司洛尔1mg/kg,以100μg/(kg.m in)持续输注直至声带息肉取出时停药。两组全麻诱导及维持采用吸入七氟烷麻醉,记录诱导前(T0)、气管插管前(T1)、插管后1min(T2)、置入支撑喉镜前(T3)、置入支撑喉镜后1min(T4)、置入支撑喉镜后5min(T5)的HR、MAP及七氟烷浓度,观察记录术后恢复时间及不良反应。结果Ⅰ组在T1时MAP及HR降低程度较Ⅱ组高,在T2、T4时点MAP及HR升高程度较Ⅱ组低,差异有统计学意义(P<0.05),I组术中麻醉维持更稳定;七氟烷浓度在T1至T5时点Ⅰ组较Ⅱ组低,差异有统计学意义(P<0.05);两组患者手术后恢复情况比较差异无统计学意义(P>0.05)。结论吸入七氟烷麻醉复合艾司洛尔静脉输注能安全、有效地维持声带息肉摘除术中的血流动力学稳定,降低应激反应,麻醉维持稳定。

Objective To study the clinical effect by total sevofiurane inhalation in combination with esmolol for excision of vocal cord polyp.Methods 60 patients were randomized into group Ⅰ（esmolol group） and Ⅱ（control group）,30 cases in each group.For group 1,2 minutes before imubation,1mg/kg of esmolol was injected intravenously followed by dose maintenance at a speed of 100μg/kg.min until the vocal cord polyps were removed.The patients of the two groups were induced and maintained with total sevofiurane inhalation.MAP,HR and sevofiurane concentration of the both groups before induction（T0）,before intubation（T1）,at minutes 1 after intubation（T2）,before laryngoscope insertion（T3）,during laryngoscope insertion（T4） and 5 minutes after laryngoscope insertion（T5） were recorded.Postoperative recovery time was also recorded.Results In group I,MAP and HR values at T1 were decreased from baseline significantly than the group Ⅱ,and values at T2,T4 were significantly lower increased than the group Ⅱ（P〈0.05）.Sevofiurane concentrations in T1-T5 point in group I were lower than group Ⅱ,statistically significant difference（P〈0.05）.The differences of postoperative recovery time in both groups were not statistically significant（P〈0.05）.Conclusion Intravenous infusion of esmolol remained safely and effectively in hemodynamic stability during total inhalation anesthesia for excision of vocal cord polyp,reduced the perioperative stress response,anesthesia was maintained stable.