不同麻醉方法用于鼻内镜手术患者麻醉效果比较

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Abstract Objective: To compare the effect of total intravenous anesthesia with sevoflurane inhalation anesthesia in endoscopic sinus surgery. Methods: Forty patients of ASA I and II undergone selective endoscopic sinus surgery were randomly divided into two groups: group T (remifentanyl 5～10 μg/kg/h and propofol 4～8 mg/kg/h maintenance anesthesia), group S (sevoflurane 0.8～1.0 MAC maintenance anesthesia), and induced by intravenous in both groups. The fluctuation of the BIS values should be controlled between 45 and 60 during the surgery. Hemodynanmic parameters including MAP, HR, and SpO2 were recorded continuously, especially before induction (T0), after induction before intubation (T1), 1 minute after intubation (T2), 3 minutes after intubation (T3), 1 minute after extubation (T4), and 3 minutes after extubation (T5). Operation time, recovery time, extubation time, the case of using hypotensive drugs during perioperation and the incidence of side effects after postoperation such as dysphoria, PONV, severe sedation were also recorded. Results: Compared with group S, the MAP at T3 and the SpO2 at T5 were declined in group T (P<0.05). Compared with T0, the MAP at T1～T3 were lower and at T4 was risen in group S (P<0.05), the HR at T4 was accelerated in group S (P<0.05). The MAP at T1～T3 was lower in group T (P<0.05), and the HR at T3 was slower in group T (P<0.05), the SpO2 at T1～T3 was risen and T5 was lower in group T (P<0.05). Compared with S group, the recovery time in group T was shorter (P<0.05), the incidence of emergence agitation in group T was lower (P<0.05), and the Ramsay sedation score in group T was higher (P<0.05), the cases of patients need controlled hypotension were less (P<0.05). Conclusion: The anesthesia effectiveness of propofol/remifentanyl intravenous anesthesia is more suitable and safer for endoscopic sinus surgery than sevoflurane inhaled maintenance anesthesia, the MAP is easier to adjust for the satisfaction of requirement of operation, revival time is faster, but incidence of agitation is loss.

Key words： total intravenous anesthesia remifentanyl propofol inhalation anesthesia sevoflurane endoscopic sinus surgery

Received: 04 April 2014

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	JIN Jianguo
	SHAN Yuanlu
	LIN Lina.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I2/139

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