电视胸腔镜手术患者应用七氟烷复合芬太尼单肺通气麻醉的效果研究

Effect Research of Sevoflurane Combined with Fentanyl on Single Lung Ventilation Anesthesia in Patients with Video Assisted Thoracic Surgery

目的:探讨电视胸腔镜(VATS)手术实施七氟烷复合芬太尼单肺通气麻醉的效果。方法:选取本院2013年7月-2015年7月接诊的VATS患者80例,按照随机数字表法将其分为对照组和研究组,每组各40例。两组均采取单肺通气麻醉,对照组麻醉药物为异氟烷+芬太尼,而研究组则为七氟烷+芬太尼,观察两组患者麻醉前、气管插管时、插管后5 min、术后10 min、术毕各个时点的平均动脉压(MAP)与心率(HR),并记录苏醒时间、拔管时间与不良反应情况。结果:两组插管后5 min的MAP均有一定降低,其中对照组与麻醉前比较差异有统计学意义(P<0.05),同时研究组明显高于对照组,差异有统计学意义(P<0.05)。两组气管插管时HR较麻醉前均明显升高,且研究组明显低于对照组,差异均有统计学意义(P<0.05)。研究组的苏醒时间、拔管时间均明显短于对照组(P<0.05);两组均有少许不良反应,但比较差异无统计学意义(P>0.05)。结论:VATS手术患者实施七氟烷复合芬太尼单肺通气麻醉可取得不错的效果,对血压与心率影响小,而且苏醒快,安全性高,值得临床借鉴与推广。

Objective：To investigate the effect of Sevoflurane combined with Fentanyl on single lung ventilation anesthesia in the video assisted thoracic surgery（VATS）.Method：80 VATS patients admitted to our hospital from July 2013 to July 2015 were selected and randomly divided into the control group and the research group,40 cases in each group.The two groups were given single lung ventilation anesthesia,the control group was anesthetized with Isoflurane and Fentanyl,the research group was anesthetized with Sevoflurane and Fentanyl.The mean arterial pressure（MAP） and heart rate（HR） at each time point such as before anesthesia,tracheal intubation,5 minutes after intubation,10 minutes after operation and completion of surgery between the two groups were observed,and the recovery time,extubation time and adverse reactions between the two groups were recorded.Result：The MAP of the two groups at 5 minutes after intubation all had certain reduction,and there was statistically significant difference compared with before anesthesia in the control group（P〈0.05）,and the research group was significantly higher than that of the control group,the difference was statistically significant（P〈0.05）.The HR of the two groups at tracheal intubation were significantly higher than before anesthesia,the research group was significantly lower than that of the control group,the differences were statistically significant（P〈0.05）.The recovery time and extubation time of the research group were significantly shorter than those of control group（P〈0.05）,there were a few adverse reactions in the two groups,but the difference was not statistically significant.Conclusion：The implementation of Sevoflurane combined with Fentanyl on single lung ventilation anesthesia in the VATS patients can achieve good results,the effect of blood pressure and heart rate are small,with rapid recovery and high security,is worthy of clinical reference and promotion.