不同全麻方法对鼻内镜手术患者全麻苏醒期躁动发生率的影响(1)
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[摘要] 目的 观察不同全麻方法对鼻内窥镜下行鼻腔手术患者全麻苏醒期躁动发生率的影响。 方法 择期在全麻鼻内窥镜下行鼻腔手术患者60例(ASA Ⅰ～Ⅱ级)，年龄18～59岁，随机分为I组(异氟醚组)、P组(异丙酚组)、PM组(异丙酚+心理准备组)，排除引起躁动的一般原因后观察三组患者全麻苏醒期躁动的发生率和离室时间。 结果 与I组相比，P组和PM组患者躁动的发生率明显减少(P < 0.05)。P组和PM组相比，差异无统计学意义(P > 0.05)，但临床观察而言，PM组患者躁动的发生率较P组少，躁动的程度亦有所减轻。 结论 鼻内窥镜手术用异丙酚静脉输注全麻替代异氟醚吸入麻醉可减少患者全麻苏醒期躁动的发生率，若同时辅以术前心理准备，则可能使此类患者全麻苏醒期恢复更趋于平稳。
[关键词] 鼻内镜手术；全麻；清醒期；躁动
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2012)06-0092-02
Effects of different methods of anesthesia on the incidence of agitation for patients undergoing endoscopic nasal surgery
GAO Hua1 SUN Li2 ZHU Liguo1
1.Department of Anesthesiology, the People’s Hospital of Wuwei County in Anhui Province, Wuwei 238300, China; 2.Department of Anesthesiology, the Sixth People’s Hospital of Shenyang City in Liaoning Province, Shenyang 116100, China
[Abstract] Objective To observe the incidence of agitation after the different methods of anesthesia for patients undergoing endoscopic nasal surgery. Methods Sixty patients (ASA Ⅰ-Ⅱ grade) who were scheduled for a nasoscopic surgery, age 18-59 years old, were randomly divided into three groups: I group (isoflurane group), P group (propofol group), PM group (propofol and mental preparation group), excluding the general reason for causing agitation, observed three groups patients the incidence of agitation of postanesthetic recovery and time away from the room. Results Compared with the A group, the incidence of agitation in B and C groups patients significantly reduced (P < 0.05). B group compared with C group, there was no significant difference (P > 0.05), but in terms of clinical observation, the incidence of agitation in C group was less than in B group, the degree of agitation was also reduced. Conclusion Endoscopic surgical alternative to propofol infusion anesthesia instead of isoflurane anesthesia to reduce the incidence of agitation of postanesthetic recovery if supplemented by preoperative mental preparation, the postanesthetic recovery period tends to be more stable.
[Key words] Endoscopic sinus surgery; General anesthesia; Emergence; Agitation
现今全身麻醉已被广泛应用于鼻内窥镜下实施鼻腔的手术中，但由于术毕患者鼻腔内填塞大量纱条止血会使患者感觉极度不适，加之习惯性呼吸道被堵塞，若处理不当会导致患者明显的躁动不安。如何安全平稳地渡过全麻苏醒期成为麻醉医生关注的问题。邓立琴等[1]分析225例患者术后躁动的原因发现：耳鼻喉手术术后躁动的发生率为55 ......
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