山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 25-27.doi: 10.6040/j.issn.1673-3770.0.2014.420

• 论著 • 上一篇    下一篇

无肌松全麻行显微镜下乳突根治术30例

王风娟1, 李传刚1, 范献良2   

  1. 1. 山东大学第二医院麻醉科, 山东 济南 250033;
    2. 山东大学第二医院耳鼻喉科, 山东 济南 250033
  • 收稿日期:2014-12-28 修回日期:2015-04-07 出版日期:2015-08-16 发布日期:2015-08-16
  • 通讯作者: 李传刚。E-mail:iamwindfeng@126.com E-mail:iamwindfeng@126.com
  • 作者简介:王风娟。E-mail:maomao2025@163.com
  • 基金资助:
    山东省优秀中青年科学家科研奖励基金项目(2011BSE27084)

General anesthesia without muscle relaxant for microsurgery of radical mastoidectomy (30 cases report).

WANG Fengjuan1, LI Chuangang1, FAN Xianliang2   

  1. 1. Department of Anesthesiology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. Department of Otorhinolaryngology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2014-12-28 Revised:2015-04-07 Online:2015-08-16 Published:2015-08-16

摘要: 目的 探讨分析采用无肌松药全麻行显微镜下乳突根治术麻醉方式的可行性。方法 显微镜下行乳突根治术患者60例, 按麻醉方式不同分为无肌松组和肌松组, 术中记录60例患者切皮时(T1)、电钻磨骨时(T2)、拔管时(T3)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP) 及心率(HR), 同时记录患者术中瑞芬太尼和丙泊酚的用量、体动反应次数、麻醉苏醒时间、拔管时间及术后不良反应。结果 两组患者的SBP、DBP、MAP及HR在T1、T2、T3时的差异有统计学意义(P<0.05), 随时间变化的趋势差异无统计学意义(P>0.05);无肌松组患者麻醉苏醒时间、拔管时间均短于肌松组, 差异有统计学意义(P<0.05);丙泊酚、瑞芬太尼用量均大于肌松组(P<0.05);术中体动反应次数差异无统计学意义(P>0.05)。肌松组患者术后出现舌后坠、低氧血症等不良反应者多于无肌松组, 差异有统计学意义(P<0.05)。结论 显微镜下乳突根治术在无肌松药的全麻方式下进行手术, 效果满意, 安全可行 。

关键词: 肌松, 乳突根治术, 全麻

Abstract: Objective To explore the feasibility of microsurgery of radical mastoidectomy under general anesthesia without muscle relaxant. Methods 60 patients with chronic otitis media under going microsurgery of radical mastoidectomy were divided into two groups randomly, with (MR group, n=30) or without (NMR group, n=30) muscle relaxant. For all the patients, SBP, DBP, MAP and HR were recorded at the time of skin incision (T1), drilling bone (T2), and extubation (T3). Meanwhile, the consumption of Propofol and Remifentanil, body movements, awakening time, time of extubation and adverse reactions were also monitored. Results There were significant differences in SBP, DBP, MAP and HR at T1, T2 and T3 between the two groups (P<0.05), but not in the trend of changes with time (P>0.05). The recovering time and time of extubation in NMR group were shorter than those of MR group (P<0.05). The consumption of Propofol and Remifentani was more in NMR group (P<0.05). The body movement showed no difference between the two groups (P>0.05). The adverse reactions of MR group, including hypoxemia, glossocoma, were more common than NMR group (P<0.05). Conclusion Microsurgery of radical mastoidectomy under general anesthesia without muscle relaxant is safer, more satisfying and feasible than that with muscle relaxant.

Key words: Muscle relaxant, Radical mastoidectomy, General anesthesia

中图分类号: 

  • R764.2
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