喉罩吸入七氟醚复合瑞芬太尼在乳腺癌根治术麻醉中应用.docVIP

喉罩吸入七氟醚复合瑞芬太尼在乳腺癌根治术麻醉中应用 　　摘要：目的：探讨喉罩吸入七氟醚复合瑞芬太尼在乳腺癌根治术麻醉的安全性和有效性。 　　方法：80例择期乳腺切除术患者随机分为观察组和对照组，观察组采用喉罩吸入七氟醚复合瑞芬太尼静脉泵注全身麻醉；对照组采用传统气管插管全凭静脉全身麻醉，观察两组患者MAP、HR、SpO2、术毕清醒时间、拔出喉罩时间及离开手术室所用时间。 　　结果：观察组术中的MAP、HR、SpO2无明显波动（P0.05）；对照组在各时点MAP、HR波动较大（P0.01）；观察组患者清醒时间、拔出喉罩时间及离开手术室所用时间均显著少于对照组（P0.01）。 　　结论：喉罩吸入七氟醚复合瑞芬太尼在乳腺癌根治术麻醉中具有血流动力学稳定，术毕恢复快等优点，安全可靠，值得临床推广。 　　关键词：喉罩 七氟醚 瑞芬太尼 乳腺癌根治术 　　Doi：10.3969/j.issn.1671-8801.2014.06.005 　　Abstract：Objective：To investigate the laryngeal mask inhalation of sevoflurane and remifentanil curative efficacy and safety of anesthesia in breast cancer. 　　Methods：80 patients undergoing mastectomy were randomly divided into the observation group and the control group，the observation group was treated with laryngeal mask inhalation of sevoflurane and remifentanil pump intravenous general anesthesia； the control group used traditional endotracheal intubation intravenous anesthesia，two groups were observed in patients with MAP，HR，SpO2，postoperative awake time，pull out the laryngeal mask time and leave the operation room with time. 　　Result：The patients in the observation group in MAP，HR，SpO2 had no obvious fluctuation （P0.05）； the control group in each time point MAP，large HR wave （P0.01）； the observation group patients awake time，pull out the laryngeal mask and leave operation room with time were significantly less than that of the control group （P0.01）. 　　Conclusion：Laryngeal mask inhalation of sevoflurane and remifentanil in breast cancer with stable hemodynamics during anesthesia，postoperative recovery is fast，safe and reliable，worthy of clinical application. 　　Keywords：laryngeal mask Sevoflurane Reventa Ni Radical mastectomy for breast cancer 　　【中图分类号】R4 【文献标识码】A 【文章编号】1671-8801（2014）06-0006-01 　　喉罩（1aryngeal mask airway，LMA）是临床麻醉气道管理上的重大突破，具有无须喉镜暴露声门、不进入声门、放置简便、刺激小等优点[1]。现已成为比较可靠、常用的上呼吸道通气方法之一，特别适用于一些肌肉松弛要求相对不高的手术中通气管理。传统的乳腺癌根治术麻醉常用的是高位硬膜外麻醉和气管插管全麻，高位硬膜外麻醉风险较大，气管插管全麻对血流动力学影响较大[2]。七氟醚是近年来广泛用于临床的一种新型吸入麻醉剂，麻醉诱导起效及苏醒迅速、循环平稳、麻醉深度易调控的特点[3]