快通道全身麻醉与硬膜外麻醉用于泌尿外科内镜手术的比较
详细信息 查看官网全文
- 论文作者：肖静 ; 罗放
- 年：2016
- 作者机构：华中科技大学同济医学院附属同济医院麻醉科;
- 论文关键词：快通道麻醉 ; 全麻 ; 硬膜外麻醉 ; 泌尿外科内镜手术
- 英文论文关键词：Fast track anesthesia ; General anesthesia ; Epidural anesthesia ; Urological endoscopic surgery
- 会议召开时间：2016-11-25
- 会议录名称：湖南中医药大学学报2016/专集：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集
- 语种：中文
- 分类号：R614
- 学会代码：HNZY
- 会议名称：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会
- 会议地点：中国广东珠海
- 主办单位：国际数字医学会、Digital Chinese Medicine
- 学会名称：湖南中医药大学期刊杂志社
- 页数：2
- 文件大小：2064k
- 原文格式：D
- 会议级别：全国
摘要
目的比较快通道全麻与硬膜外麻醉用于泌尿外科内镜手术的术床周转率及麻醉不良事件。方法选择择期行泌尿外科内镜手术的患者135例,平均分为三组:A组:连续硬膜外麻醉组,B组:无肌松喉罩快通道全身麻醉组,C组:气管插管快通道全身麻醉组。记录麻醉前、硬膜外腔注药/全麻醉插管即刻、手术结束时MAP,术中平均HR,术中使用血管活性药物的例数,记录麻醉操作时间,手术时间以及麻醉期不良反应以及并发症。结果三组间血压及心率变化无统计学差异。B组(8.20±3.48 min)和C组(8.76±3.69 min)麻醉操作时间明显短于A组(24.24±7.27 min),(P<0.01)。A组麻醉不良事件发生率(17.8%)较B组(2.2%)和C组(4.4%)高(P<0.01);各组手术时间无明显差异。结论与连续硬膜外麻醉相比,快通道全身麻醉用于泌尿外科腔镜手术具有术床周转率高,麻醉并症少的优势。
Objective To compare the rate of operating table turnover and adverse reactions and complications of anesthesia between Fast-track general anesthesia and epidural anesthesia forurological endoscopic surgery. Methods 135 patients who undergoing elective urological endoscopic surgery were divided into three groups. Group A: continuous epidural anesthesia group. Group B: laryngeal mask fast track general anesthesia group without muscle relaxant. Group C: endotracheal intubation fast track general anesthesia. The MAP before anesthesia, at the time of epidural injectionor intubation and at the end of the surgery were recorded; also we recorded the average HR during operation, the number of use of vascular active drugs, the anesthesia operation time, the operation time, and the adverse reactions and complications during perianesthesia period. Results There were no statistical difference in blood pressure and heart rate among the three groups. Anesthesia operation timein group A(24.24 ± 7.27 min) was significantly longer than that of group B(8.20 ± 3.48 min) and group C(8.76 ± 3.69 min)(P < 0.01), however, there was no statistical difference between group B and C. The three groups had no significant difference in operation time. Conclusion Compared with continuous epidural anesthesia, fast track general anesthesia may speed up the turnover rate of operatingtable for urological endoscopic surgery with few adverse reaction and complications.
Objective To compare the rate of operating table turnover and adverse reactions and complications of anesthesia between Fast-track general anesthesia and epidural anesthesia forurological endoscopic surgery. Methods 135 patients who undergoing elective urological endoscopic surgery were divided into three groups. Group A: continuous epidural anesthesia group. Group B: laryngeal mask fast track general anesthesia group without muscle relaxant. Group C: endotracheal intubation fast track general anesthesia. The MAP before anesthesia, at the time of epidural injectionor intubation and at the end of the surgery were recorded; also we recorded the average HR during operation, the number of use of vascular active drugs, the anesthesia operation time, the operation time, and the adverse reactions and complications during perianesthesia period. Results There were no statistical difference in blood pressure and heart rate among the three groups. Anesthesia operation timein group A(24.24 ± 7.27 min) was significantly longer than that of group B(8.20 ± 3.48 min) and group C(8.76 ± 3.69 min)(P < 0.01), however, there was no statistical difference between group B and C. The three groups had no significant difference in operation time. Conclusion Compared with continuous epidural anesthesia, fast track general anesthesia may speed up the turnover rate of operatingtable for urological endoscopic surgery with few adverse reaction and complications.
引文
[1]Martin-Larrauri R,Gilsanz F,Rodrigo J,et al.Conventional stepwise vs vital capacity rapid inhalation induction at two concentration of sevoflurane.Eur J Anaesthesiol,2004,21(4):265-271
[2]Boonmak P,Boonmak S,Pattanittum P.High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia.Cochrane Database Syst Rev.2012 Sep 12;9:CD006837.doi:10.1002/14651858.CD006837.pub2.
[3]Lin CF,Yang CY,Chao E,et al.Shortrm inhalation of sevoflurane during induction of general anesthesia can inhibit the A-line ARX indexresponse to intubation:a randomized trial.Chang Gung Med J.2011 Nov-Dec;34(6):599-606.
[4]Kim JY,Chang YJ,Lee JY,et al.Post-induction alfentanil reduces sevoflurane-associated emergence agitation in children undergoing an adenotonsillectomy.Acta Anaesthesiol Scand.2009 May;53(5):678-81.doi:10.1111/j.1399-6576.2009.01943.x.
[5]冯翠,戚思华,邹玉梅,等.右美托咪啶联合芬太尼对七氟醚麻醉诱导患者的影响.中华医学杂志.2012,17;92(27):1889-91.
[6]Kavalci G1,Ethemoglu FB,Durukan P,et al.Comparison of the effects of dexmedetomidine and remiphentanyl on emergence agitation after sevofluraneanesthesia in adults undergoing septoplasty operation:a randomized double-blind trial.Eur Rev Med Pharmacol Sci.2013Nov;17(22):3019-3023.
[7]李腾成,吴杰英,湛海伦,等.输尿管上段结石两种麻醉方法的前瞻性随机对照研究(附视频).中华腔镜泌尿外科杂志.2013,7(6):432-436.
[2]Boonmak P,Boonmak S,Pattanittum P.High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia.Cochrane Database Syst Rev.2012 Sep 12;9:CD006837.doi:10.1002/14651858.CD006837.pub2.
[3]Lin CF,Yang CY,Chao E,et al.Shortrm inhalation of sevoflurane during induction of general anesthesia can inhibit the A-line ARX indexresponse to intubation:a randomized trial.Chang Gung Med J.2011 Nov-Dec;34(6):599-606.
[4]Kim JY,Chang YJ,Lee JY,et al.Post-induction alfentanil reduces sevoflurane-associated emergence agitation in children undergoing an adenotonsillectomy.Acta Anaesthesiol Scand.2009 May;53(5):678-81.doi:10.1111/j.1399-6576.2009.01943.x.
[5]冯翠,戚思华,邹玉梅,等.右美托咪啶联合芬太尼对七氟醚麻醉诱导患者的影响.中华医学杂志.2012,17;92(27):1889-91.
[6]Kavalci G1,Ethemoglu FB,Durukan P,et al.Comparison of the effects of dexmedetomidine and remiphentanyl on emergence agitation after sevofluraneanesthesia in adults undergoing septoplasty operation:a randomized double-blind trial.Eur Rev Med Pharmacol Sci.2013Nov;17(22):3019-3023.
[7]李腾成,吴杰英,湛海伦,等.输尿管上段结石两种麻醉方法的前瞻性随机对照研究(附视频).中华腔镜泌尿外科杂志.2013,7(6):432-436.