中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2013年
2期
148-150
,共3页
麻醉药,全身%麻醉,吸入%佐剂,麻醉%七氟烷%喉罩
痳醉藥,全身%痳醉,吸入%佐劑,痳醉%七氟烷%喉罩
마취약,전신%마취,흡입%좌제,마취%칠불완%후조
Anesthetics,general%Anesthesia,inhalation%Adjuvants,anesthesia%Sevoflurane%Laryngeal mask airway
目的 探讨老年人全身麻醉诱导期七氟烷吸入联合喉罩通气的使用效果,为临床合理应用七氟烷及喉罩提供指导.方法 选择40例老年全身麻醉患者,使用随机数字法分为两组,每组20例.S组(七氟烷吸入联合喉罩通气组)采用“肺活量法”吸入诱导,待患者意识消失后置入喉罩.C组(对照组)采用单次静注咪达唑仑、芬太尼、维库溴铵、异丙酚依次诱导,诱导后经口插入气管导管.记录两组患者诱导前(T0),插管前(T1),插管后1 min (T2),插管后5 min (T3)的收缩压(SBP),舒张压(DBP),心率(HR),Narcotrend指数(NTI)及两组患者诱导期间有无屏气、呛咳、喉痉挛等反应.结果 S组插管前、插管后1 min、插管后5 min血压、心率与诱导前差异无统计学意义(P＞0.05).C组插管前血压[(108.6±8.1) mm Hg,1 mmHg=0.133 kPa]、插管后5 min血压[(114.7±7.5)mm Hg]、插管前心率[(65.5±8.9)次/min]、插管后5 min心率[(66.9±7.8)次/min],插管后1 min血压[(157.5±11.2) mm Hg]、心率[(88.4±8.0)次/min],较诱导前差异有统计学意义(P＜0.05).S、C组插管前(T1),插管后1 min(T2),插管后5 min(T3)的SBP、DBP、HR差异有统计学意义(P＜0.05).两组患者NTI差异无统计学意义(P＞0.05),诱导过程均未出现屏气、呛咳、喉痉挛、支气管痉挛等反应.结论 在老年人全身麻醉诱导期使用七氟烷吸入联合喉罩通气,血流动力学平稳,麻醉深度适宜,且诱导过程平稳.
目的 探討老年人全身痳醉誘導期七氟烷吸入聯閤喉罩通氣的使用效果,為臨床閤理應用七氟烷及喉罩提供指導.方法 選擇40例老年全身痳醉患者,使用隨機數字法分為兩組,每組20例.S組(七氟烷吸入聯閤喉罩通氣組)採用“肺活量法”吸入誘導,待患者意識消失後置入喉罩.C組(對照組)採用單次靜註咪達唑崙、芬太尼、維庫溴銨、異丙酚依次誘導,誘導後經口插入氣管導管.記錄兩組患者誘導前(T0),插管前(T1),插管後1 min (T2),插管後5 min (T3)的收縮壓(SBP),舒張壓(DBP),心率(HR),Narcotrend指數(NTI)及兩組患者誘導期間有無屏氣、嗆咳、喉痙攣等反應.結果 S組插管前、插管後1 min、插管後5 min血壓、心率與誘導前差異無統計學意義(P＞0.05).C組插管前血壓[(108.6±8.1) mm Hg,1 mmHg=0.133 kPa]、插管後5 min血壓[(114.7±7.5)mm Hg]、插管前心率[(65.5±8.9)次/min]、插管後5 min心率[(66.9±7.8)次/min],插管後1 min血壓[(157.5±11.2) mm Hg]、心率[(88.4±8.0)次/min],較誘導前差異有統計學意義(P＜0.05).S、C組插管前(T1),插管後1 min(T2),插管後5 min(T3)的SBP、DBP、HR差異有統計學意義(P＜0.05).兩組患者NTI差異無統計學意義(P＞0.05),誘導過程均未齣現屏氣、嗆咳、喉痙攣、支氣管痙攣等反應.結論 在老年人全身痳醉誘導期使用七氟烷吸入聯閤喉罩通氣,血流動力學平穩,痳醉深度適宜,且誘導過程平穩.
목적 탐토노년인전신마취유도기칠불완흡입연합후조통기적사용효과,위림상합리응용칠불완급후조제공지도.방법 선택40례노년전신마취환자,사용수궤수자법분위량조,매조20례.S조(칠불완흡입연합후조통기조)채용“폐활량법”흡입유도,대환자의식소실후치입후조.C조(대조조)채용단차정주미체서륜、분태니、유고추안、이병분의차유도,유도후경구삽입기관도관.기록량조환자유도전(T0),삽관전(T1),삽관후1 min (T2),삽관후5 min (T3)적수축압(SBP),서장압(DBP),심솔(HR),Narcotrend지수(NTI)급량조환자유도기간유무병기、창해、후경련등반응.결과 S조삽관전、삽관후1 min、삽관후5 min혈압、심솔여유도전차이무통계학의의(P＞0.05).C조삽관전혈압[(108.6±8.1) mm Hg,1 mmHg=0.133 kPa]、삽관후5 min혈압[(114.7±7.5)mm Hg]、삽관전심솔[(65.5±8.9)차/min]、삽관후5 min심솔[(66.9±7.8)차/min],삽관후1 min혈압[(157.5±11.2) mm Hg]、심솔[(88.4±8.0)차/min],교유도전차이유통계학의의(P＜0.05).S、C조삽관전(T1),삽관후1 min(T2),삽관후5 min(T3)적SBP、DBP、HR차이유통계학의의(P＜0.05).량조환자NTI차이무통계학의의(P＞0.05),유도과정균미출현병기、창해、후경련、지기관경련등반응.결론 재노년인전신마취유도기사용칠불완흡입연합후조통기,혈류동역학평은,마취심도괄의,차유도과정평은.
Objective To investigate the effects of sevoflurane with laryngeal mask airway (LMA) on elderly patients during general anesthesia induction,thus offering the rationale for clinical application.Methods Forty patients with ASA Ⅰ to Ⅱ scheduled for general anesthesia were enrolled and,by using a random number table,allocated to group S (sevoflurane + LMA group) to undergo inhalation induction at the level of vital capacity followed by placement of LMA when unconscious,and group C (control group) to receive sequential anesthesia by intravenous midazolam,fentynil,vecuronium and propofol,and subsequent placement of catheter transorally.The heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP) and Narcotrend index (NTI) were monitored prior to induction (T0),before intubation (T1),1min (T2) and 5 min following intubation (T3).The presence of breath-holding,bucking and laryngospasm was also monitored.Results The differences in BP and HR in group S at T1,T2 and T3 were not statistically significant when compared with T0 (all P＞0.05).Group C was characterized by significant variation in BP [(108.6±8.1mm) Hg at T1,(157.5±11.2) mm Hg at T2 and (114.7±7.5) mm Hg at T3,1 mm Hg=0.133kPa] and HR [(65.5±8.9)/min at T1,(88.4±8.0)/min at T2 and (66.9±7.8)/min at T3] when compared with that at T0 (all P＜0.05).Significant changes in SBP,DBP and HR,but not NTI,were noted at T1,T2 and T3 in groups S and C (P＜0.05).No signs of breath-holding,bucking and laryngospasm were reported during intubation.Conclusion The combination of sevoflurane with LMA yields stable hemodynamics,appropriate depth of anesthesia and stabilized induction for anesthesia in the elderly patients.
