摘要
目的观察依托咪酯联合瑞芬太尼静脉全身麻醉在喉显微手术中的安全性。方法择期行喉显微手术患者120例，ASAI～Ⅱ级，随机分为两组，分别为丙泊酚组（I组）和依托咪酯组（Ⅱ组），每组各60例。所有患者采用全凭静脉麻醉，其中I组采用丙泊酚联合瑞芬太尼诱导及维持，Ⅱ组采用依托咪酯联合瑞芬太尼诱导及维持，观察比较两组患者术中血流动力学变化、术后苏醒情况及血浆中皮质醇浓度。结果两组患者术后苏醒情况无明显差异。各组患者术中SBP、DBP、MBP、HR值在T1、T2、T3、T4时较TO时明显降低（P〈0．05），T2时较T1、T3、T4时升高．差异有统计学意义（P〈0．05）；两组间各时点比较差异无统计学意义（P〉0．05）。两组患者在Tl、T4时皮质醇浓度较同纽TO时降低，但差异无统计学意义（P〉0．05）；两组间各时点比较差异无统计学意义（P〉0．05），两组患者药品不良反应比较差异无统计学意义（P〉0．05）。结论依托咪酯联合瑞芬太尼静脉全身麻醉可安全应用于喉显微手术，苏醒快，血流动力学平稳。
Objective To observe the safety and scientific of etomidate combined with remifentanil intravenous anesthesia in laryngeal microsurgical operation. Methods 120 patients undergoing microlaryngoscopic surgery, ASA I-II, were randomly divided into two groups, respectively for propofol group （ group i ） and etornidate group （ group II ） , 60 cases in each group. All were treated with total intravenous anesthesia. The group I by remifentanil combined with propofol for induction and maintenance, group II used etomidate combined with remifentanil in induction and maintenance, the postoperative hemodynamic changes, postoperative recovery and plasma cortisol concentrations in the two groups of patients were observed and compared. Results No obvious difference was found between two groups of patients with postoperative awakening situation. Groups of patients with intraoperative the values of SBP, DBP, MBP, HR in T1, T2, T3, T4 were significantly decreased compared with TO （P〈0.05） , and when compared with T1, T3, T4, the values of T2 were elevated, the difference was statistically significant （ P〈0.05 ） . Each point comparing differences between two groups had no statistical significance （P〉0.05） . The cortisol concentration of two groups of patients in T1, T4 were lower compared with in TO, but there were no statistically significant difference （ P〉0.05 ） , and the cortisol concentration in each point comparing differences between two groups had no statistical significance （ P〉0.05 ） , and were within the normal range. And between two groups there was no statistical difference in adverse drug reactions （ P〉0.05 ） . Conclusions Etomidate combined with remifentanil intravenous anesthesia can be applied safely in laryngeal microsurgery with rapid recovery and hemodynamics stable.
出处
《浙江临床医学》
2018年第1期161-162,共2页
Zhejiang Clinical Medical Journal
关键词
依托咪酯
瑞芬太尼
喉显微手术
皮质醇
Etomidate Remifentanil Microlaryngoscopic operation Cortisol
