喉罩七氟醚吸入对甲亢手术患者血流动力学的影响

Effect of sevoflurane anesthesia combined with laryngeal mask airway on haemodynamics of the patients undergoing hyperthyroidism surgery

目的观察喉罩七氟醚吸入麻醉对甲亢手术患者血流动力学的影响。方法 60例ASAI～II级择期在全麻下实施甲亢手术的患者,随机分为七氟醚吸入组(S组)和丙泊酚组(P组)。观察两组诱导及清醒情况。在麻醉诱导前(T0)、插入喉罩前(T1)、插入喉罩即刻(T2)、切皮即刻(T3)、拔除喉罩前(T4)、拔除喉罩后即刻(T5)记录SPO2、PETCO2、HR、MAP。结果两组清醒时间差异无统计学意义。与T0比较T1、T2时S组MAP下降(P<0.05);T1、T2时P组HR减慢、MAP下降(P<0.05);T1、T2时P组MAP低于S组(P<0.05);T2时HR慢于S组(P<0.005)。结论七氟醚吸入麻醉用于甲亢手术,血流动力学更稳定,手术期间可维持接近生理状态的血流动力学,全麻后苏醒平稳。

Objective To investigate the effects of sevoflurane anesthesia combined with laryngeal mask on haemodynamics of patients in hyperthyroidism surgery. Methods Sixty hyperthyroid, ASA Ⅰ or Ⅱ , scheduled for elective hyperthyroidism surgery were randomly divided into sevoflurane inhalation anesthesia group（ group S） and propofol intravenous anesthesia group（ group P）. The status of anesthesia induction or recovery was observed. The following data were recorded and statistical analyzed, SpO2, PETCO2, HR and MAP at time points of before anesthesia induction（ TO ） , before laryngeal mask intubation（ T1 ）, after laryngeal mask intubation immediately （ T2 ）, skin incision （ T3 ）, before laryngeal mask extubation （ T4 ）, after laryngeal mask extuba tion immediately （ T5 ）. Results Recovery time wasn＇ t significantly different in two groups. Compared with those at To, MAP at T1 or T2 were significantly lower in group S （ P 〈 0. 05 ）. HR, MAP at T1 or T2 were significanly lower than those at To in group P （ P 〈 0. 05 ）. MAP at T1 or T2 in group P was significanly lower than those in group S （P 〈 0.05 ）. HR at T2 in group P was significantly lower than that in group S （ P 〈 0.05 ）. Conclusion It provided more stabile haemodynamics, cardiac output and systemic vascular resistance approximated to normal condition and equable recovery in sevoflurane anesthesia with laryngeal mask airway.