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    术后低剂量丙泊酚维持麻醉对声带息肉摘除术病人血流动力学及苏醒期躁动影响

    Effect of low dose propofol maintenance anesthesia on the hemodynamics and recovery agitation after vocal cord polypectomy

      摘要
    • 摘要:
      目的分析术后低剂量丙泊酚维持麻醉对声带息肉摘除术病人血流动力学及苏醒期躁动的影响。
      方法选取100例需行声带息肉摘除术的病人，按照随机数字表法将其分为观察组和对照组，各50例。对照组病人采用常规麻醉方案，观察组病人手术结束后缓慢给予静脉注射丙泊酚0.5 mg/kg。观察并记录2组病人性别、年龄、体质量、手术时间、术中出血等一般资料，治疗前后心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2），2组病人手术后躁动评分以及苏醒期恢复情况包括自主呼吸恢复时间、睁眼、拔管、躁动发生率。
      结果2组病人术毕时HR、MAP均较术前明显下降（P < 0.01），拔管时HR、MAP较术毕时显著升高（P < 0.01），观察组拔管时HR、MAP显著低于对照组（P < 0.01），2组病人HR、MAP拔管后30 min均较术前降低（P < 0.01）；2组病人拔管时SpO2显著降低（P < 0.01），拔管后30 min较拔管时恢复（P < 0.01）。手术后不同时刻，观察组病人躁动评分低于对照组（P < 0.05~P < 0.01）；2组内术后不同时刻躁动评分差异均有统计学意义（P < 0.01），拔管时躁动评分显著高于苏醒时和拔管后30 min（P < 0.01）。2组病人拔管时间差异无统计学意义（P > 0.05），观察组病人自主呼吸恢复时间及睁眼时间显著大于对照组（P < 0.01），观察组间躁动发生率显著低于对照组（P < 0.01）。
      结论术后低剂量丙泊酚维持麻醉能有效减少声带息肉摘除术病人血流动力学波动及苏醒期躁动，而病人呼吸恢复时间及睁眼时间有所增加。

       

      Abstract:
      ObjectiveTo investigate and analyze the effects of low dose propofol maintenance anesthesia on hemodynamics and recovery agitation in patients with vocal cord polypectomy.
      MethodsOne hundred patients scheduled by vocal cord polypectomy were divided into the observation group and control group according to random number table method(50 cases each group).The control group was treated with routine anesthesia, and the observation group was treated with 0.5 mg/kg propofol by intravenous injection.The gender, age, body weight, operation time and intraoperative bleeding in two groups were observed, heart rate(HR), mean arterial pressure(MAP) and oxygen saturation(SpO2) before and after operation, agitation score, recovery during recovery period (including the recovery time of spontaneous breathing, eye opening, extubation and incidence rate of agitation) in two groups were analyzed.
      ResultsHR and MAP of patients in two groups were significantly lower than those before operation(P < 0.01), HR and MAP were significantly higher at extubation, HR and MAP in observation group were significantly lower than those in control group(P < 0.01), HR and MAP in two groups were significantly lower 30 minutes after extubation(P < 0.01), SpO2 in two groups was significantly lower at extubation(P < 0.01), and recovered 30 minutes after extubation(P < 0.01).At different time after operation, the restlessness score of the observation group was lower than that of control group(P < 0.05 to P < 0.01).There was a significant difference in the restlessness score between the two groups at different time after operation(P < 0.01).The restlessness score at extubation was significantly higher than that at awakening and 30 minutes after extubation(P < 0.01).There was no significant difference in extubation time between the two groups(P > 0.05).The recovery time of spontaneous breathing and the opening time of eyes in the observation group were significantly longer than those in the control group(P < 0.01), and the incidence of restlessness in the observation group was significantly lower than that in the control group(P < 0.01).
      ConclusionsThe low dose propofol maintenance anesthesia can effectively reduce the fluctuation of hemodynamics and recovery agitation, and improve the breathing recovery time and opening eye time in patients with vocal cord polypectomy.

       

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