快通道麻醉在腔镜甲状腺切除术中的应用

Application of fast-track anesthesia in endoscopic thyroidectomy

目的观察两种快通道麻醉方法在腔镜甲状腺切除术中的应用效果。方法选择ASAⅠ~Ⅱ级,年龄18~55岁,拟行腔镜甲状腺切除术的患者30例,随机分为两组：丙泊酚组（P组,n=15）和七氟烷组（S组,n=15）。前者采用丙泊酚维持麻醉,后者采用七氟烷维持麻醉。观察记录两组患者术中平均动脉压（MAP）和心率（HR）的变化,记录苏醒时间、拔管时间、定向力恢复时间及PACU停留时间,并随访记录围麻醉期的不良反应。结果两组患者在麻醉诱导后MAP即HR均有显著下降（P〈0.05）,P组患者比S组患者下降更明显（P〈0.05）;S组患者的苏醒时间、拔管时间和定向力恢复时间均显著短于P组患者（P〈0.05）;但S组患者诱导期出现呛咳现象多于P组患者（P〈0.05）。结论丙泊酚和七氟烷均可用于腔镜甲状腺切除术快通道麻醉。

Objective To observe the clinical effect of two kinds of fast-track anesthesia in endoscopic thyroidectomy.Methods Thirty ASA Ⅰ～Ⅱ grade patients undergoing endoscopic thyroidectomy,aged 18～55 years,were randomly divided into propofol group（Group P,n=15） and sevoflurane group（Group S,n=15）.Propofol and sevoflurane was administered during maintenance of anesthesia,respectively.The mean arterial pressure（MAP） and heart rate（HR） during operation were observed and recorded.The awakening time,extubation time,orientation time and PACU stay time in two groups were recorded.The side-effect during anesthesia were investigated.Results The MAP and HR in two groups obviously decreased after anesthesia induction（P0.05）.The MAP and HR in Group P decreased more than that in Group S（P0.05）.The awakening time,extubation time and orientation time in Group S were significantly shorter than that in Group P（P0.05）.However,more irritating cough happened in Group S（P0.05）.Conclusion Both propofol and sevoflurane are safe and effective alternative to fast-track anesthesia in endoscopic thyroidectomy.