表面麻醉联合全身麻醉在支撑喉镜下声带手术中临床应用.docVIP

表面麻醉联合全身麻醉在支撑喉镜下声带手术中临床应用 　　摘 要 目的：观察表面麻醉联合全身麻醉在支撑喉镜下声带手术中的效果。方法：选择ASAⅠ～Ⅱ级择期行支撑喉镜下声带手术患者60例，随机分成全身麻醉组(G组)和表面麻醉联合全身麻醉组(C组)，每组30例，比较两组血液动力学变化、术毕呼吸恢复时间、拔管时间、意识恢复情况、全麻药用量、术后咽喉部疼痛VAS评分等。结果：G组的血压、心率在插管后，置入支撑喉镜时、拔管前都明显高于诱导前(?P?＜0.05)；术中全麻药用量G组明显多于C组(?P?＜0.05)；C组术毕呼吸恢复时间、拔管时间明显短于G组(?P?＜0.05)；患者意识情况、术后咽喉部疼痛VAS评分C组明显优于G组。结论：表面麻醉联合全身麻醉用于支撑喉镜下声带手术方法简单，术中血液动力学平稳、苏醒迅速完全、镇痛满意。? 　　关键词 表面麻醉 全身麻醉 支撑喉镜 声带? 　　doi:10.3969/j.issn.1007-614x.2012.06.186?? 　　Abstract Objective:To observe the effects of surface anesthesia combined general anesthesia in the surgery of vocal cord with self-retaining laryngoscope.Methods:Sixty ASA Ⅰ or Ⅱ Patients undergoing Selective vocal cord surgery with self-retaining laryngoscope were randomly divided into two groups with 30 cases each.One group received general anesthesia(group G)and another group received surface anesthesia combined general anesthesia(group C).Compare the haemodynamics,the times of recovering spontaneous breath removing tracheal tube,recovering of consciousness dosage of anesthesia and VAS Score of postoperative threat pain of two groups.Results:Bp and HR increased significantly in group G during intubation compared that of induction period(?P?＜0.05).The recovery times of respiration,extubation and consciousness of group C was significantly shorter than those of group G(?P?＜0.05).The VAS score of group C was significantly less than that of group G(?P?＜0.05).Conclusion:Application of surface anesthesia combined with general anesthesia in the surgery of vocal cord with self-retaining laryngoscope is safe with stable hemodynamics simple,and satisfiled in faster recovery,postoperative analgesia.? 　　Key Words Surface anesthesia;General anesthesia;Self-retaining laryngoscope;Vocal cord 　　支撑喉镜下声带手术由于其手术精细、手术时间短、咽喉刺激大、麻醉和手术共用一个气道而对麻醉提出更高的要求。本文采用表面麻醉复合全身麻醉的方法，观察支撑喉镜下声带手术的麻醉效果及对患者苏醒期质量的影响。 　　资料与方法 　　选择ASA Ⅰ～Ⅱ级择期行支撑喉镜下声带手术患者60例，男21例，女39例，其中声带息肉38例，声带小结12例，声带囊肿10例，年龄19～68岁，体重40～75kg，无心脑血管病变，随机分为全麻组(G组)和联合组(C组)，每组30例。 　　麻醉方法：所有患者均不用术前药，入室后开