瑞芬太尼在支撑喉镜下声带息肉手术中的应用

目的将瑞芬太尼用于支撑喉镜下声带息肉摘除术,并试以脑电双频谱指数(Bispectral index,BIS)评价其麻醉深度。方法选择15例声带息肉患者静注阿托品0.5mg,瑞芬太尼1μg/kg,丙泊酚1.5mg/kg,司可林1.5mg/kg后气管插管。然后用丙泊酚以100μg/kg/min、瑞芬太尼0.3μg/kg/min静脉泵入,1%司可林静脉滴注维持麻醉直至手术结束。结果麻醉诱导后血压有不同程度的下降。插管和支撑喉镜置入对血压无明显影响。心率在每个观察时点没有明显差异。BIS值在诱导后渐渐下降,插管与支撑喉镜置入未能使BIS值上升。而唤醒与拔管时的BIS值明显升高。结论瑞芬太尼、丙泊酚用于支撑喉镜声带息肉手术麻醉深度适宜,麻醉效果满意,作用时间短,恢复迅速平稳。

The Application of Remifentanil Anesthesia on Vocal Polyps Extirpationby Self-retaining Laryngoscope

Objective To study the application of remifentanil anesthesia on vocal polyps extirpation by self-retaining laryngoscope,and evaluate the depth of anesthesia by bispectral index. Methods 15 patients of vocal polyps were given atropine 0.5mg,remifentanil 1ug/kg,propofol 1.5mg/kg,scoline1.5mg/kg before intubation.Then continually infused propofol 100ug/kg/min,remifentanil 0.3 ug/kg/min,maintaining infusion of 1% scaling until the end of the operation. Results The blood pressure dropped by different extent after anesthesia inducement.Intubation and posting self-retaining laryngoscope have no significant influences on the blood pressure. The heart rate had no distinct variation at each observing point.The BIS scores declined after inducement.Intubation and posting self-retaining laryngoscope were unable to increase the BIS scores,while the BIS scores of waking and estuation increased distinctively. Conclusions The effects of intraoperative anesthesia depth with remifentanil and propofol used for vocal polyps extirpation by self-retaining laryngoscope are suitable and satisfying,with less persistence,speedy and steady recovery as well.