经喉罩自主吸入七氟醚在胸腔镜手术中的应用

The application of laryngeal mask airway for spontaneous breathing under sevoflurane anesthesia in the thoracoscopic operation

目的评价经喉罩自主吸入七氟醚麻醉应用于胸腔镜手术中的临床效果。方法将65例行胸腔镜手术的患者随机分为两组:丙泊酚组(1组,33例)和七氟醚组(2组,32例),比较两组患者麻醉后心率、平均动脉压、PETCO2、术后恢复时间以及麻醉并发症的发生率等指标。结果两组患者的心率和平均动脉压较麻醉前大多出现下降趋势(P<0.05),但七氟醚组的心率和平均动脉压水平高于丙泊酚组(P<0.05)。七氟醚组的麻醉并发症发生率为18.75%,小于丙泊酚组的24.24%。七氟醚组患者术后苏醒时间、拔管时间和OAA/S分级达到5级的时间均短于丙泊酚组(P<0.05)。结论经喉罩自主吸入七氟醚麻醉在胸腔镜手术中血流动力学稳定,安全性高,术后恢复快。

Objective To evaluate the anesthesia efficacy of laryngeal mask airway for spontaneous breathing under sevoflurane anesthesia in patients undergoing video-assisted thoracoscopic surgery(VAST).Methods Sixty-five patients undergoing VAST were randomly divided into propofol group(group 1,n=33)and sevoflurane group(group 2,n=32).Indexes such the heart rate(HR),mean arterial pressure(MAP),PETCO2,postoperative recovery time,and the incidence of anesthesia complications were recorded and compared between the two groups.Results HR and MAP of patients in both groups mostly decreased after anesthesia(P<0.05),but the levels of HR and MAP of sevoflurane group were higher than those of propofol group(P<0.05).The incidence of anesthesia complications in sevoflurane group was 18.75%,which was lower than that in propofol group(24.24%).The postoperative recovery time,extubation time,the time of OAA/S grading reaching grade 5 of sevoflurane group were shorter than those of propofol group(P<0.05).Conclusion Laryngeal mask airway for spontaneous breathing under sevoflurane anesthesia,maintains the steadiness of haemodynamics,is more effective and safer,has a faster postoperative recovery than intravenous propofol anesthesia in thoracoscopic operation.