不同全麻维持方式对胃肠外科手术患者苏醒期躁动的影响

Influence of different patterns of general anesthesia maintainance on incidence of emergence agitation in patients scheduled for gastrointestinal surgery

目的:探讨不同全麻维持方式对胃肠外科手术患者苏醒期躁动的影响。方法:择期胃肠外科手术患者160例,相同麻醉方案诱导后,分为4组(每组40例),A组全凭静脉麻醉;B1和B2组静吸复合麻醉,B1组手术结束前停止吸入麻药时间≤25min,B2组手术结束前停止吸入麻药时间>25min;C组全凭吸入麻醉(术毕间断吸除机械无效腔气体)。记录手术时间、麻醉维持时间和苏醒期躁动发生率。结果:4组手术时间和麻醉维持时间比较,差异均无统计学意义(F=0.498和0.870,P>0.05)。4组躁动发生率相比,差异有统计学意义(χ2=18.824,P<0.001),其中B1组躁动发生率高于其他3组(P<0.008)。结论:全凭静脉麻醉,全凭吸入麻醉及静吸复合麻醉、停止吸入麻药到手术结束时间>25min者躁动发生率低,麻醉医师可根据患者情况选择适合的麻醉维持方式。

Aim：To observe the influence of different patterns of general anesthesia（GA） maintainance on incidence of emergence agitation（EA） in patients scheduled for gastrointestinal surgery.Methods：A total of 160 patients scheduled for gastrointestinal surgery were allocated into four groups,40 in each group,and induced with the same anesthesia prescription.Group A maintained GA with total intravenous anesthesia;group B1 and B2,with combined intravenous and inhalation anesthesia：for group B1,the inhalation stop to operation end was controlled within 25 min,and for group B2,which was controlled over 25 min;group C maintained GA with total inhalation（the mechanical invalid cavity gas was exhausted after operation discontinously）.The surgical duration,anesthesia time and EA incidence were recorded.Results：The operation duration and anesthesia time among the four groups had no statistical significance（F=0.498,0.870,P0.05）,while the EA incidence existed significant difference（χ2=18.824,P0.001）,among which,the EA incidence in group B1 was higher than those in the other 3 groups（P0.008）.Conclusion：The incidences of EA for total intravenous anesthesia,total inhalation,and combined intravenous and inhalation anesthesia with early stop of inhalation are low,and can be chosen accordingly.