异丙酚用于声带显微手术麻醉的临床观察

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30例ASAⅠ~Ⅱ级择期行声带显微手术的患者,随机分为两组:Ⅰ组15例,采用异丙酚为主的静脉麻醉;Ⅱ组15例应用硫喷妥钠诱导,普鲁卡因维持麻醉。Ⅰ组全部患者有满意的插管条件,插管、操作中血流动力学平稳;Ⅱ组与基础值比较,置支撑喉镜后2min的收缩压(SBP)、舒张压(DBP)、心率(HR),置支撑喉镜10min的DBP有显著性差异(P<005)。两组间比较,诱导插管后1min的SBP、HR,置支撑喉镜2min的SBP、DBP、HR,均有显著性差异(P<005)。停麻醉药后,Ⅰ组56min呼之睁眼,1107min拨管,比Ⅱ组恢复迅速,有显著差异(P<005)。Ⅰ组在临床应用中未发现严重不良反应,苏醒过程平稳,无烦燥不安等症状,清醒后呕吐1例,Ⅱ组清醒后呕吐5例,两组间有显著性差异(P<005)。结论:异丙酚诱导麻醉起效迅速,用于术中维持,可明显抑制支撑喉镜置入时的心血管副反应,且苏醒迅速,苏醒期及术后不良反应少,是此类手术较好的麻醉方法之一。 Thirty ASA Ⅰ ~ Ⅱ patients undergoing elective microscopical vocal cord microsurgery were randomly divided into two groups: group Ⅰ (n = 15), propofol-based intravenous anesthesia; group Ⅱ (n = 15) Because of maintaining anesthesia. All patients in group Ⅰ had satisfactory conditions for intubation. During intubation and intubation, the hemodynamics were stable in group Ⅱ. SBP, DBP and heart rate in group Ⅱ were significantly higher than those in group Ⅱ HR) and DBP with support laryngoscope for 10 minutes (P <005). The SBP, HR, SBP, DBP, HR at 1 min after induction of intubation were significantly different between the two groups (P <005). After stopping anesthesia, Ⅰ group 5 6min call open eyes, dial 1107min, compared with the rapid recovery group Ⅱ, there was a significant difference (P <0  05). In group Ⅰ, no serious adverse reactions were found in clinical application, and the symptoms of wakefulness were stable without irritability. One case of vomiting after awake and five cases of vomiting after awake in group Ⅱ showed significant difference between the two groups (P <005 ). CONCLUSION: Propofol-induced anesthesia has a rapid onset of anesthesia and can be used for intraoperative maintenance. It can significantly inhibit cardiovascular side effects during laryngoscope placement and prompt recovery, less awakening and less postoperative adverse reactions. One of the good anesthesia methods.
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