改良快速顺序诱导用于快速康复外科全麻患者的效果观察

摘要

Objective To observe the clinical effect of the modified rapid sequence induction used in patients undergoing general anesthesia in fast-track surgery.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 30-65 yr,weighing 45-67 kg,scheduled for gastric cancer,colorectal cancer surgery under general anesthesia were randomly divided into two groups (n =30 each):the observation group undergoing modified rapid sequence induction and the control group undergoing conventional rapid induction.The time of operation and anesthesia was recorded.Intra-gastric pressure and pharyngeal pH value were measured at the time of pre-induction (T1) and post-induction (T2).Meanwhile,the time of first flatus,length of primary hospital stays and cost of hospital admission were recorded.Results No difference were noted in the time of operation and anesthesia between the two groups (all P ＞ 0.05).Compared with T1,the intra-gastric pressure and the pharyngeal pH value at T2 in the observation group were not significantly different (all P ＞ 0.05),while that in the control group was significantly increased (P ＜ 0.05,P ＞ 0.05 respectively).Compared with the control group,the time of first flatus was significantly less,the length of primary hospital stays and the cost of hospital admission were significantly reduced in the observation group (all P ＜ 0.05).Conclusion The modified rapid sequence induction can be effectively used in general anesthesia patients,which can accelerate the recovery of gastrointestinal function,reduce length of primary hospital stays and cost of hospital admission.%目的 观察改良快速顺序诱导用于快速康复外科全麻患者的临床效果.方法 选择60例接受快速康复外科围术期治疗模式的胃癌、结直肠癌根治术全麻患者,随机分为观察组和对照组各30例,分别行改良快速顺序诱导及常规快速顺序诱导.记录麻醉时间和手术时间,监测麻醉诱导前(T1)、麻醉诱导后(T2)胃内压和口咽部分泌物pH值,记录术后首次肛门排气时间、住院时间和住院费用.结果 两组麻醉时间和手术时间比较差异均无统计学意义(P均＞0.05);与T1时点比较,T2时点观察组胃内压、口咽部分泌物pH值均无显著变化(P均＞0.05),对照组均升高(P分别＜0.05、＞0.05);与对照组比较,观察组术后首次肛门排气时间及住院时间均明显缩短、住院费用明显减少(P均＜0.05).结论 改良快速顺序诱导用于快速康复外科全麻患者,可促进其术后胃肠功能恢复、缩短住院时间和减少住院费用.