七氟烷和瑞芬太尼用于声带息肉摘除术麻醉的比较

目的比较七氟烷和瑞芬太尼麻醉用于声带息肉摘除手术中血压和心率的变化。方法选择ASAⅠ～Ⅱ级、择期行声带息肉摘除术患者60例,随机分为两组：七氟烷吸入麻醉组（S组）和瑞芬太尼静脉麻醉组（R组）。七氟烷组给予吸入七氟烷,浓度为4%～6%;瑞芬太尼组持续泵注瑞芬太尼20～40μg/kg,入室至麻醉苏醒期间连续观察收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）,记录停药至苏醒时间及苏醒质量,记录患者苏醒期并发症的发生数。结果在气管插管时R组HR、SBP、DBP均高于S组（P〈0.05）,同时R组的HR、SBP均高于基础值（P〈0.05）;支撑喉镜植入后1 min时R组的HR、SBP、DBP明显低于S组（P〈0.05）,S组的SBP、DBP明显高于基础值（P〈0.05）。结论瑞芬太尼和七氟烷均可用于声带息肉摘除术中的麻醉,但是七氟烷对循环系统尤其对心率的干扰较小,可安全有效地用于该类手术的麻醉。

Comparison of sevoflurane and remifentanil for vocal cord polyp operation anesthesia

Objective To compare the effects of sevoflurane and remifentanil anesthesia on blood pressure and heart rate in vocal cord polyp operation. Methods Sixty patients（ASAⅠ - Ⅱ）scheduled for polyp of vocal cord removal were randomly di-vided into two groups. Group S were given anaesthetic maintenance with 4% - 6% ,while group R were given anaesthetic mainte-nance with continuous infusion of remifentanil（20 - 40）μg/ kg instead. The changes of SBP,DBP,HR,SpO2 from entering op-eration room were observed. The time from drug withdrawal to palinesthesia,the quality of palinesthesia and the complication in the recovery period were recorded. Results The levels of HR,SBP,DBP were significant higher in group R than those in group S while tracheal intubation（P 〈 0. 05）;At the same time,the levels of HR,SBP in group R were higher than those in base value （P 〈 0. 05）. HR,SBP,DBP were significantly lower while insertion laryngoscope in group R than those in group S（P 〈 0. 05）. SBP,DBP in group S were significantly higher than those in basal value（P 〈 0. 05）. Conclusion Remifentanil and sevoflurane can be used for anesthesia in vocal cord polyp,but the sevoflurane has little interference on circulatory system,especially on heart rate,it can be used safely and effectively in the anesthesia of vocal cord polyp.