摘要
目的：观察眼底手术中全身麻醉保留自主呼吸的临床效果。方法：眼底手术患者260例,男172例,女88例,年龄18-79岁,平均（48±14）岁。分为气管插管控制呼吸组（A组）130例和喉罩保留自主呼吸组（B组）130例。A组患者给予丙泊酚、芬太尼、维库溴铵等药物,进行气管插管控制呼吸全身麻醉。B组给予维库溴铵、丙泊酚、盐酸右美托嘧啶、曲马多、氯化琥珀酰胆碱等药物置入可弯曲喉罩,保留自主呼吸全身麻醉,必要时（PETCO2〉50mmHg）行手控辅助呼吸。两组患者均给予球后神经阻滞并吸入2.5%-3.5%的七氟醚维持麻醉,术后包头和包头开始前10分钟停用七氟醚。记录麻醉期间相关时间点患者的血压,血氧饱合度,心率,呼吸等,观察术中血流动力学及呼吸参数,以及术后恢复质量、不良反应发生率等。结果：A组气管插管及拔管时血压及心率都有所升高,B组插管时及插管后15min内心率减慢,差异显著（P〈0.05）。两组血氧无差异（P〉0.05）,PETCO2 B组较A组略高（P〈0.05）;拔管时间及手术后的苏醒时间B组均优于A组（P〈0.05）;围手术期出现并发症B组明显低于A组（P〈0.05）。结论：成人眼底手术中全身麻醉保留自主呼吸能有效地降低围术期并发症的发生,患者苏醒快,恢复时间短,是安全可靠的。
Objective： To observe clinical effects of spontaneous breathing reserved in retinal surgery under general anesthesia. Methods： Retinal surgery 260 cases, 172 cases of male, female 88 cases, aged 18 to 79 years, mean （48±14） years of age. Divided into control breathing intubation group （group A） and spontaneous respiration LMA group （group B）. 130 cases of each. A group of patients given propofol, fentanyl and vecuronium drugs, controlled breathing intubation under general anesthesia. Group B received vecuronium, propofol, dexmedetomidine hydrochloride, tramadol ,succinylcholine chloride and lfexible LMA intubated during general anesthesia with spontaneous breathing, which be changed to manual ventilation if necessary（PETCO2〉50mmHg）. Two groups of patients were given retrobulbar nerve block and inhalation of 2.5%-3.5% sevolfurane, which deactivated in postoperative bandaging head or ten minutes before the bandaging. Patients＇ blood pressure, oxygen saturation, heart rate,respiration and so on were recorded at the relevant time points during anesthesia, the hemodynamic and respiratory parameters observed, as well as the quality of postoperative recovery, incidence of adverse reactions, etc.Results：Blood pressure and heart rate of group A elevated during endotracheal intubation and extubation while heart rate in group B slowed down while or 15min after intubation, the difference was significant （P〈0.05）. There＇s no significantly difference in two groups＇ oximetry（P〉0.05）, PETCO2 slightly higher in group B than that of group A（P〈0.05）;Group B was superior to group A as far as extubation time and recovery time after surgery was concerned（P〈0.05）; Perioperative complications in group B was signiifcantly lower than that in group A （P〈0.05）.Conclusions：Adult retinal surgery under general anesthesia with spontaneous breathing can effectively reduce the incidence of perioperative complications in patients with rapid recovery, recovery time is short, it is safe
出处
《中国医药导刊》
2014年第7期1111-1112,1114,共3页
Chinese Journal of Medicinal Guide
关键词
喉罩
眼底手术
自主呼吸
Laryngeal mask
Retinal surgery
Spontaneous Breathing
