七氟烷麻醉诱导用于口腔手术患者无肌松药气管插管临床研究.docVIP

七氟烷麻醉诱导用于口腔手术患者无肌松药气管插管临床研究 　　[摘要] 目的：观察七氟烷在口腔手术患者无肌松药麻醉诱导插管中的临床效果。方法：将96例口腔手术的患者（ASAⅠ～Ⅲ级）随机分成对照组（静脉诱导气管插管）和试验组（七氟烷吸入诱导气管插管）。观察诱导插管过程中躁动发生率、插管满意度、不良反应及对循环功能的影响。结果：两组均能顺利完成气管插管，从开始吸入七氟烷到意识消失的时间为（78.9±7.7）s。一次操作插管成功率对照组和试验组分别为93.75%和79.17%（P=0.011）。试验组发生屏气、轻微呛咳、体动者明显多于对照组（P 　　[关键词] 七氟醚；麻醉诱导；气管插管 　　[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210（2011）11（a）-024-03 　　 　　Clinical study on induction with sevoflurane for tracheal intubation without muscle relaxant in oral surgery 　　ZENG Dezuo, LI Tiejun*, OUYANG Bishan 　　Department of Anaesthesiology, Hainan Provincial Peoples Hospital, Haikou 570311, China 　　[Abstract] Objective: To observe the clinical effectiveness of inductions and tracheal intubating conditions with sevoflurane without muscle relaxant in oral surgery. Methods: 96 cases of oral surgery patients (American Society of Anesthesiologists grade Ⅰ-Ⅲ) were randomly divided into control group (induction of tracheal intubation by vein) and experiment group (induction of tracheal intubation by sevoflurane inhalation). Agitation, intubating satisfactoriness, incidence of adverse events and the circulation changes after anesthesia induction and tracheal intubation were observed. Results: The time period from sevoflurane inhalation to disappearance of consciousness was (78.9±7.7)s, and all patients were successfully intubated with sevoflurane. The achievement ratio of induction was 79.17% in experiment group and 93.75% in control group at the first attempt, there was a significant difference (P=0.011). There were more patients had agitation, breathholding, cough, body movement and breathing in experiment group compared with control group (P 　　1.2 方法 　　事先准备两组不透明信封，每组4个，信封内分别装入写有S、S、P、P各一张纸条。患者入手术室后由参与本课题但不参与气管插管的上级医生随机抽取一组信封内的1个信封，信封内纸条写S入试验组，写P则入对照组。下一次分配患者入组时在该组剩下的3个信封中随机抽取1个信封，按照上述原则入组，直至该组4个信封抽取完再抽取下一组信封，依此类推，轮流使用。 　　术前1 d访视患者，重点了解有无困难插管、气道手术经历，有无打鼾、颈粗短、先天性面颌畸形、牙齿突出、颞颌关节强直以及颈部肿物、瘢痕、气管移位等情况，估测张口度、甲颏距离、寰枕关节伸展度和采用Mallampantis试验对气管插管可能存在的困难进行评估。 　　患者入