两种麻醉方法用于支撑喉镜老年患者声带息肉手术的效果比较

目的：比较七氟醚和丙泊酚用于支撑喉镜老年患者声带息肉手术的麻醉效果。方法：择期拟行声带息肉手术患者90例,随机分为七氟醚组（Sev组）和丙泊酚组（Pro组）,每组45例。Sev组给予4%七氟醚吸入联合瑞芬太尼、琥珀胆碱静脉诱导气管插管,术中七氟醚吸入联合瑞芬太尼、琥珀胆碱静脉维持麻醉。Pro组给予丙泊酚1mg/kg联合瑞芬太尼、琥珀胆碱静脉诱导气管插管,术中丙泊酚联合瑞芬太尼、琥珀胆碱静脉维持麻醉。记录并比较两组患者麻醉前,插管前、插管后平均动脉压（MAP）、心率（HR）的变化,比较两组术后苏醒时间、拔管时间的差异。结果：麻醉前、插管后两组血流动力学参数比较,差异无统计学意义,插管前Pro组MAP、HR显著低于Sev组（P〈0.05）;Sev组术后苏醒时间及拔管时间均显著低于Pro组（P〈0.05）。结论：七氟醚用于支撑喉镜老年声带息肉手术的麻醉时,对血流动力学影响较轻,能显著缩短术后苏醒时间和拔管时间,是一种安全有效的麻醉方法。

Comparison of Anesthetic Effect of Two Methods for Elderly Patients with Vocal Polyp Operation Via Self-retaining Laryngoscope

Objective： To compare the anesthetic effect of sevoflurane and propofol severally used to the elderly patients with vocal polyp operation via self-retaining laryngoscope. Method： Ninety ASA Ⅰ-Ⅱ patients, schedules for elective vocal polyp operation, via self-retaining laryngoscope were selected in the study.There were randomly divided into sevoflurane group （ Sev group ） and propofol group （ Pro group ）, 45 cases in each group. Patients of Group Sev were given 4% sevoflurane inhalation combined with reminfentinil and succinylcholine intravenous induction before tracheal intubation, intraoperativly inhaled sevoflurane combined with remifentanil and succinylcholine intravenous anesthesia. Patients of Group Pro were given propofol （ lmg/kg ） combined with remifentanil and succinylcholine intravenous induction before tracheal intubation, intraoperativly inhaled sevoflurane combined with remifentanil and succinylcholine intravenous anesthesia. The mean arterial pressure （ MAP ）, heart rate （ HR ） of patients in two groups were recorded and compared before anesthesia, before intubation, after cannulation. Recovery time and extubation time of patients in two groups were recorded and compared. Result： Hemodynamic parameters of patients between two groups were not significantly different before anesthesia and after cannulation. MAP, HR of Group Prowere significantly lower than those of Group Sev before intubation （ P〈0.05 ） . Recovery time and extubation time of Group Sev were significantly shorter than those of Group Pro （ P〈0.05 ） . Conclusion： Effects of sevoflurane inhalation anesthesia in elderly patients with vocal polyp operation via self-retaining laryngoscope on hemodynamic were lighter. This method of anesthesia can significantly reduce the postoperative recovery and extubation time. it is a safe and effective anesthesia method.