摘要
目的 比较脑电双频指数(bispectral index, BIS)监测下,异丙酚与七氟烷复合舒芬太尼诱导下宫腔镜检查术患者的喉罩置入条件。方法 纳入2022年4月至7月在北京大学第三医院妇科接受喉罩全麻下宫腔镜检查术的患者200例,随机数字表法平均分为2组,丙泊酚组(n=100)和七氟烷组(n=100)。丙泊酚组采用异丙酚复合舒芬太尼进行麻醉诱导;七氟烷组采用“改良的肺活量法”七氟醚吸入复合舒芬太尼进行麻醉诱导。结果 患者中4例临时改变手术方案,4例术中数据收集不全,8例失访,未获得完整数据,最终纳入184例,每组92例。两组患者麻醉诱导时长、喉罩置入一次成功率和喉罩置入容易度评分差异均无统计学意义(P>0.05);七氟烷组喉罩置入过程中患者体动发生率低(2%vs 10%),但刺激性气味报告率比丙泊酚注射痛报告率更高(75%vs 45%),差异有统计学意义(P<0.05)。两组患者均未出现喉痉挛、反流误吸等严重并发症,术后咽喉痛(postoperative sore throat, POST)发生率较低。患者术后麻醉满意度均较高。结论 七氟烷和丙泊酚联合舒芬太尼麻醉诱导,均可为喉罩置入提供良好的置入条件。七氟烷气道刺激不适发生率高于丙泊酚注射痛,患者体动发生率低。
Objective To compare the laryngeal mask placement conditions in patients undergoing propofol and sevoflurane under the bispectral index(BIS)monitoring.Methods This study was conducted from April to June 2022 at Peking University Third Hospital.200 patients who were scheduled for hysteroscopy under general anesthesia with a laryngeal mask airway were enrolled.The patients were assigned to the sevoflurane group(n=100)and propofol group(n=100).In propofol group,propofol combined sufentanil was used for anesthesia induction;in sevoflurane group,anesthesia induction was performed using a"modified spirometry"sevoflurane inhalation with compound sufentanil.Results Among the patients,4 patients temporarily changed the surgical protocol.4 patients had incomplete intraoperative data collection.8 patients were lost to follow-up,and no complete data were obtained,finally including 184 patients and 92 patients in each group.There was no significant difference in patient anesthesia induction duration,primary success rate of laryngeal mask placement,and ease of laryngeal mask placement score(P>0.05).Compared to propofol group,patients in sevoflurane group had a lower incidence of body movement(2%vs 10%),but the pungent odor reporting rate was higher than propofol injection pain (75% vs 45%). The difference was statistically significant (P<0. 05). No serious complications such as laryngeal spasm and reflux aspiration occurred in both groups, and the incidence of postoperative sore throat (POST) was low. The satisfaction of postoperative anesthesia was high. Conclusion Sevoflurane and propofol in combination with sufentanil anesthesia induction can provide good placement conditions for laryngeal mask placement. The incidence of airway discomfort with sevoflurane irritation was higher than propofol injection pain, and the incidence of patient movement was low.
作者
赵丹
李谨
田蒙
刘莉
ZHAO Dan;LI Jin;TIAN Meng;LIU Li(Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China)
出处
《延安大学学报（医学科学版）》
2023年第3期83-86,共4页
Journal of Yan'an University:Medical Science Edition
关键词
丙泊酚
七氟烷
喉罩置入
注射痛
气道刺激
Sevoflurane
Propofol
Laryngeal mask placement
Injection pain
Airway irritation
