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依托咪酯喉罩全麻在颅内动脉瘤介入手术中的应用

庞德春   

  1. 广西钦州市第一人民医院麻醉科
  • 收稿日期:2012-06-15 修回日期:2012-12-29 出版日期:2013-05-15 发布日期:2013-05-15
  • 通讯作者: 庞德春

  • Received:2012-06-15 Revised:2012-12-29 Published:2013-05-15 Online:2013-05-15

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摘要： 【摘要】 目的  探讨依托咪酯喉罩全麻在颅内动脉瘤介入手术中的可行性与安全性。方法  行颅内动脉瘤介入手术并ASA分级Ⅰ～Ⅲ级患者62例,随机分丙泊酚气管插管组(PE组)31例和依托咪酯喉罩组(EL组)31例。记录麻醉前(T0)、麻醉诱导(T1)、插喉罩或气管导管时(T2)、拔喉罩或气管导管时(T3)4个时点的收缩压(SBP)、舒张压(DBP)、心率(HR),血氧饱和度(SpO2)、呼气末二氧化碳[p(CO2)]的变化,并观察停药后呼唤睁眼时间、拔管(罩)时间、定向力恢复时间以及术后24h烦躁及恶心、呕吐的发生情况。结果  2组患者的SBP、DBP、HR在T0比较差异无统计学意义(P>0.05);T1时点PE组上述指标低于EL组,T2、T3时点PE组高于EL组(P<0.01)。术中2组SPO2、呼末p(CO2)差异无统计学意义(P>0.01)。停药后EL组呼唤睁眼时间、拔管(罩)时间、定向力恢复时间均短于PE组(P<0.01)。结论 依托咪酯喉罩全麻用于颅内动脉瘤介入手术具有血流动力学稳定、苏醒快等优点,是一种安全可靠的麻醉方式。

关键词: 依托咪酯, 全身麻醉, 颅内动脉瘤, 喉罩, 临床方案, 介入手术

Abstract: 【Abstract】 objective  To investigate etomidate laryngeal mask general anesthesia in interventional surgery of intracranial aneurysm in safety and feasibility,and compared with endotracheal intubation propofol general anesthesia. Methods  choose elective intervention surgery of intracranial aneurysm 62 patient,ASA:Ⅰ~Ⅲ,were randomly divided into two groups:31 in etomidate emulsion by laryngeal mask(group EL) and 31 in propofol by endotracheal intubation(group PE),recorded and compare before anesthesia（T0）、after induction of anesthesia(T1)、when the endotracheal tube(LMA) inserted(T2)、surgery(T3)、when the endotracheal tube(LMA) pulling(T4) in SBP、DBP、HR、SPO2、PETCO2 values; observe the recovery time of the spontaneous breathing and orientation after stopped anesthetic,24h after surgery the incidence of restlessness、nausea and vomiting;Results  Compared with T0,EL group T1 point BP、HR decreased,the difference was not statistically significant(p>0.05);PE group BP,HR decreased significantly, group and the difference between group was statistically significant(p<0.05).EL group call eye opening time after stopped anesthetic,orientation recovery time,LMA removal time was shorter than the PE group,the the difference was statistically significant(p<0.05); SPO2 and PETCO2 difference between two groups was statistically significant(p>0.05).Conclusion   etomidat laryngeal mask general anesthesia with the advantages of steady hemodynamic and rapid awakening,is a safe and reliable anesthesia, and compared with endotracheal intubation propofol general anesthesia. is more suitable for interventional surgery of intracranial aneurysm.

Key words: Etomidate, general anesthesia, Intracranial aneurysm, the clinical programs, interventional procedures