异丙酚用于喉部手术前气管切开的临床观察

The clinic observation of propofol anesthesia in patients during tracheostomy before largngectomy

目的观察异丙酚在喉部手术前行气管切开期间应用的可行性及安全性。方法选择择期喉部手术患者24例,每组12例,随机分为异丙酚组(Ⅰ组)和局麻组(Ⅱ组)。Ⅰ组患者在局麻前给予异丙酚1～2mg/kg缓慢静脉注射,待患者睫毛反射消失、意识丧失后给予1%利多卡因局部浸润再行气管切开。Ⅱ组患者仅在1%利多卡因局部浸润下行气管切开。记录切皮前、切皮时、插管时、插管后1min、插管后3min时患者心率(HR)、平均动脉压(MAP)及脉搏氧饱和度(SPO2),观察患者呼吸抑制发生率,燥动发生率及术后遗忘率。结果切皮时,插管时及插管后1min,3minⅡ组患者心率(HR)、平均动脉压(MAP)较Ⅰ组患者明显升高,躁动发生率Ⅱ组患者明显高于Ⅰ组患者(P<0.05),呼吸抑制发生率及脉搏氧饱和度(SPO2)变化无明显差异(P>0.05)。结论异丙酚用于喉部手术前气管切开安全可行。

Objective:To observe the feasibility and security of propofol anesthesia in patients during tracheostomy before largngectomy.Methods:Twenty-four patients scheduled for tracheostomy in local anesthesia before largngectomy,were randomly divided into two groups.The patients in group Ⅰreceived propofol 1-2mg.kg-1 by intravenous infusion,and after sense disappeared,received local infiltration anesthesia by 1% lidocaine before skin incision;Group Ⅱ received only local anesthesia by 1% lidocaine.Hemodynamics?respiratory depression?accurrance of fidget and postoperative amnesia were recorded respectively.Results:HR and MAP in group Ⅱ were higher than in group Ⅰ during skin incision,intubation and after intubation 1 min and 3 min(P<0.05),The respiratory depression and SPO2 of the two group have no apparent differences(P>0.05),The accurrance of fidget in group Ⅱ was higher than in group Ⅰ(P<0.05).Conclusion:Propofol used in the tracheostomy before largngectomy is comparatively safe and feasible.