CAJ | 학술논문

目的探讨氟比洛芬酯对鼻内窥镜(functional endoscopic sinus surgery,FESS)手术七氟醚全麻术后躁动的预防作用.方法择期全麻下FESS手术40例,美国麻醉医师协会(theAmerican Society of Anesthesiologists,ASA)Ⅰ～Ⅱ级健康成人,采用随机双盲对照方法,将患者分成3组,术毕前15分钟分别静脉注射氟比洛芬酯50mg(实验组T组),芬太尼1μg·kg-1(对照组F组),等体积生理盐水组(空白对照组C组).记录患者入手术室后10分钟(T1)、插管后5分钟(T2)、手术开始后5分钟(T3)、拔管后5分钟(T4)的心率、平均动脉压;观察各组术后躁动发生率、清醒情况、拔管时间和恶心呕吐发生率.结果 ①与C组相比,T组和F组拔管后躁动发生率明显减少(P<0.05);②C组患者与T组和F组相比,拔管后5分钟心率和平均动脉压明显增高(P<0.05);③T组拔管时间和苏醒时间与C组相当,均明显少于F组(P<0.05);④三组恶心呕吐发生率无明显差别.结论健康成人静脉注射50mg氟比洛芬酯可以减少FESS手术七氟醚全麻术后躁动的发生,不明显延长拔管苏醒时间,不增加恶心呕吐发生率.
목적 탐토불비락분지대비내규경(functional endoscopic sinus surgery,FESS)수술칠불미전마술후조동적예방작용.방법 택기전마하FESS수술40례,미국마취의사협회(theAmerican Society of Anesthesiologists,ASA)Ⅰ～Ⅱ급건강성인,채용수궤쌍맹대조방법,장환자분성3조,술필전15분종분별정맥주사불비락분지50mg(실험조T조),분태니1μg·kg-1(대조조F조),등체적생리염수조(공백대조조C조).기록환자입수술실후10분종(T1)、삽관후5분종(T2)、수술개시후5분종(T3)、발관후5분종(T4)적심솔、평균동맥압;관찰각조술후조동발생솔、청성정황、발관시간화악심구토발생솔.결과 ①여C조상비,T조화F조발관후조동발생솔명현감소(P<0.05);②C조환자여T조화F조상비,발관후5분종심솔화평균동맥압명현증고(P<0.05);③T조발관시간화소성시간여C조상당,균명현소우F조(P<0.05);④삼조악심구토발생솔무명현차별.결론 건강성인정맥주사50mg불비락분지가이감소FESS수술칠불미전마술후조동적발생,불명현연장발관소성시간,불증가악심구토발생솔.
Objective To investigate the effects of the intravenously administra-tion of flurbiprofen axetil injection on agitation after functional endoscopic sinus surgery with sevoflurane general anesthesia. Methods A total of 40 patients aged from 18 years to 60 years in good health (ASA physical status Ⅰ～Ⅱ ) undergoing elective functional endoscopic sinus surgery were randomly and respectively divided into three groups. The patients were induced with fentanyl and propofol and rocuronium, and maintained with 2.5%～3.5% sevoflurane and oxygen. In group T, flurbiprofen axetil injection 50mg were administrated 15 minutes before the end of operation, and fentanyl 1μg/kg in group F, and in group C was given an equal volume of NS. The heart rate (HR), mean arterial blood pressure (MAP) were assessed during the anesthesia. The extubation time, waking time, postoperative agitation, nausea and vomiting were observed and recorded. Results The agitation was remarkably suppressed in group T and group F than group C. And there was a significant difference in mean heart rate and mean arterial blood pressure in group C compared with group T and F. And the extubation time and waking time were almostly the same in group T and group C, and both shorter than that in group F. The rate of nausea and vomiting were not increased in the group T. Conelusion It is safe and feasible to give flurbiprofen axetil injection 50mg to reduce agitation after functional endoscopic sinus surgery with sevoflurane general anesthesia.