不同麻醉方法对心脏手术后早期拔管的影响

Effect of anesthetic techniques on postoperotive early tracheal extubation of cardiac surgery

目的 :比较异氟醚、异丙酚麻醉与大剂量芬太尼麻醉对先心病患者术后清醒时间、拔除气管导管 (简称拔管 )时间的影响。方法 :芬太尼组 ( Fen组 )麻醉维持以芬太尼为主 ,异氟醚组 ( Iso组 )麻醉维持以异氟醚为主 ,异丙酚组( Pro组 )持续滴注异丙酚。观察术后清醒时间、拔管时间。结果 :清醒时间和拔管时间 Iso组和 Pro组均比 Fen组短 ,差异有非常显著性 ( P<0 .0 1) ,且前两组患者无拔管后再插管。结论 :异氟醚或异丙酚心脏麻醉有利于术后早期拔管 ,减少术后呼吸系统并发症 ,对患者的心血管系统无明显的不良影响 ,同时减少了患者在 ICU的停留时间 。

Objective:To compare the effects of consciousness recovery(CR)time,tracheal extubatioin(TE)time in three groups.Methods:Group Fen was maintained with fentanyl,group Iso was maintained with isoflurane and group Pro with propofol.CR time,TE time were observed.Results:CR time and TE time in group Iso and group Pro are shorter than that in group Fen( P <0.01).There is no reintubtion in group Iso and Pro.Conclusions:Administration of isoflurane or proplfol is benefit of postoperative early tracheal extubation.It may reduce the complications of respiratory system,and no obvious side effects of cardiovascullar system.Therefore,it will short the length of stay(LOS)in the intensive care unit(ICU)and reduce the cost of medial care.