全麻下双肺同期手术病人自然苏醒与催醒的比较

Comparison between awakening naturally and promoting awakening in adult patients undergoing bilateral pulmonary surgery after general anesthesia

目的比较全麻下双肺同期手术病人自然苏醒和拮抗药催醒状况。方法选取我院全麻双侧肺同期手术病人100例,随机分两组,A组为自然苏醒组,B组为拮抗药催醒组,观察停用全麻药和拔管时两组病人的MAP、HR、脉搏氧饱和度(SPO2);记录A组病人停全麻药后和B组病人给拮抗药后2、4、6、8、10 min各时点患者的CSI值;记录病人苏醒期能按指令睁眼时间、拔管时间、回麻醉恢复室监测时间;记录病人苏醒期躁动、苏醒延迟病例数。结果 B组注药后CSI在各时点的值与A组病人比较差异有统计学意义(P<0.05);B组对按指令睁眼时间、拔管时间、麻醉恢复室监测时间均短于A组(P<0.05);B组苏醒期躁动和苏醒延迟发生例数明显少于A组。结论全麻下双侧肺同期手术病人恢复期拮抗药催醒可减少病人苏醒延迟和躁动等并发症的发生,缩短全麻恢复时间。

Objective To compare the effects of awakening naturally and promoting awakening with injecting antagonist in adult patients undergoing bilateral pulmonary surgery after general anesthesia.Methods One hundred adult patients undergoing bilateral pulmonary surgery after general anesthesia from June 2009 to June 2011 were divided into two groups.Patients in Group A were awakening naturally,while those in Group B were given antagonist intravenously.MAP、HR and SPO2 were assessed and compared between the two groups.CSI was recorded and compared every two,four,six,eight and ten minutes.The time of awakening and extubating,duration of patient staying in post-anesthesia care unit（PACU）,and incidence of postoperative agitation were recorded for study.Results The different CSI indicators at various point of time between the two groups were statistically meaningful（P〈0.05）;the time of awakening and extubating for Group B was earlier;duration of patient staying in PACU was shorter（P〈0.05）;incidences of postoperative agitation were as much fewer in Group B than that in group A.Conclusion Antagonist works effectively on adult patients undergoing bilateral pulmonary surgery after general anesthesia in relieving postoperative agitation and in shortening analepsia period.