七氟烷麻醉诱导用于口腔手术患者无肌松药气管插管的临床研究

目的：观察七氟烷在口腔手术患者无肌松药麻醉诱导插管中的临床效果。方法：将96例口腔手术的患者（ASAI～Ⅲ级）随机分成对照组（静脉诱导气管插管）和试验组（七氟烷吸入诱导气管插管）。观察诱导插管过程中躁动发生率、插管满意度、不良反应及对循环功能的影响。结果：两组均能顺利完成气管插管，从开始吸入七氟烷到意识消失的时间为（78．9±7．7）s。一次操作插管成功率对照组和试验组分别为93．75％和79．17％（仕：0．011）。试验组发生屏气、轻微呛咳、体动者明显多于对照组（P〈0．05），麻醉诱导时间也明显延长（4．96±2：13）minvs（6．92＋3．20）min，P=0．001]，但插管过程中保有自主呼吸率为77．08％。试验组插管后即刻MBP和HR较对照组显著升高（P〈0．01）。结论：七氟醚用于口腔科患者麻醉诱导，麻醉深度可控性好，血流动力学较平稳，无严重呼吸道并发症，虽有一定比例躁动但均能顺利完成插管，对于困难气管插管患者是个更好的选择。

Clinical study on induction with sevoflurane for tracheal intubation without muscle relaxant in oral surgery

Objective： To observe the clinical effectiveness of inductions and tracheal intubating conditions with sevoflu- rane without muscle relaxant in oral surgery. Methods： 96 cases of oral surgery patients （American Society of Anesthesiologists grade I -III ） were randomly divided into control group （induction of tracheal intubation by vein） and experiment group （induction of tracheal intubation by sevoflurane inhalation）. Agitation, intubating satisfactoriness, incidence of adverse events and the circulation changes after anesthesia induction and tracheal intubation were observed. Results： The time period from sevoflurane inhalation to disappearance of consciousness was （78.9±7.7）s, and all patients were successfully intubated with sevoflurane. The achievement ratio of induction was 79.17% in experiment group and 93.75% in control group at the first attempt, there was a significant difference （P=0.011）. There were more patients had agitation, breathholding, cough, body movement and breathing in experiment group compared with control group （P〈0.05）, anaesthesis induction time （6.92±3.20）min vs （4.96±2.13）rain, P=0.001], the rate of autonomous respiration was 77.08% in the tracheal intubation. The MAP and HR were higher immediately after tracheal intubation in experiment group compared with control group （P〈0.01）. Conclusion： Induction with sevoflurane in oral surgery is a safe,effective and convenient technique, the depth of anesthesia is controllable, and the hemodynamies is stable, no serious complications of airway, and can achieve the tracheal intubation successfully, although agitation is more common during induction with sevoflurane. The application of sevoflu- rane in the difficult airway intubation can decrease the risk of intubation with less adverse events.