瑞芬太尼全麻下喉罩在高龄患者阑尾切除术中的临床应用

目的:探讨瑞芬太尼全麻下喉罩通气用于高龄患者阑尾切除术的有效性与安全性。方法:选择高龄患者60例,ASAⅡ或Ⅲ级,随机分为气管插管组(T组)和喉罩通气组(L组),每组30例。记录麻醉诱导前(T0)、麻醉诱导后(T1)、插管或置入喉罩即刻(T2)、切皮时(T3)、进腹探查后5 min(T4)、拔除气管导管或喉罩(T5)各个时点的平均动脉压(MAP)与心率(HR)变化及苏醒质量。结果:2组之间以及不同时间MAP、HR差异均有统计学意义(P0.05～P0.01);组间因素与时间水平间的交互效应具有统计学意义,且T组高于L组(P0.05)。L组的苏醒时间及拔管时间均短于T组(P0.01),术后躁动发生率低于T组(P0.05)。结论:瑞芬太尼全麻喉罩用于高龄患者阑尾切除术效果确切,血流动力学稳定,苏醒快,副作用少。

The clinical application of laryngeal mask in eldly with appendectomy using remifentanil anesthesia

Objective:To explore the efficacy and safety of laryngeal mask in eldly with appendectomy using remifentanil anesthesia.Methods:Sixty cases with ASA Ⅱ or Ⅲ were randomly divided into the intubation group(group T,30 cases) and the laryngeal mask group(group L,30 cases).The levels of mean arterial pressure(MAP) and heart rate(HR) and awakening quality were recorded at different time-points of before and after induction of anesthesia(T0,T1),laryngeal mask insertion(T2),cuting skin(T3),after 5 min entering abdomen(T4) and pulling out the laryngeal mask(T5).Results:The difference of MAP and HR of two groups had statistically significant(P<0.05 to P<0.01).The factors and the interaction effects of time of group T was significantly higher than that of group L(P<0.05).Compared with group T,the extubation and recovery time and the incidence of postoperative agitation of group L were less(P<0.05 to P<0.01).Conclusions:Laryngeal mask for eldly with appendectomy using remifentanil anesthesia general anesthesia has good anesthetic effects,stabile hemodynamics,and fast recovery,and less side effects.