两种气管导管拔除方法对心血管反应及苏醒质量的影响比较

摘要

目的 观察两种不同拔除气管导管的方法对患者心血管反应及苏醒质量的影响.方法 60例ASA Ⅰ～Ⅱ级全麻择期手术患者随机分组为改良拔管组(A组,n=30)和传统拔管术组(B组,n=30).两组患者全麻诱导及麻醉维持方法相同,术毕前20 min停吸异氟醚,5 min后停用丙泊酚,术毕立即静脉注射氟马西尼0.5 mg.于意识恢复(呼唤有反应),自主呼吸时潮气量＞7 ml/kg、呼吸频率＞12次/min、脱管Sp02＞92%、呼吸道防御反射恢复和静脉注射新期的明、阿托品后拔除气管导管.结果 与B组比较,A组拔管前后SBP、DBP、MAP和Sp02与诱导前相比差异无统计学意义(P＞0.05).结论 改良拔管术能有效降低全麻围拔管期的心血管反应,苏醒质量改善.%Objective To observe two different methods of tracheal extubation on the cardiovascular response and wake quality.Methods 60 patients with ASA Ⅰ ～ Ⅱ grade of general anesthesia for elective surgery were randomly assigned into improved extubation group (A group,n=30) and conventional extubation group (B group, n = 30). It was the same way that the induction of general anesthesia and the maintenance of anesthesia method in two groups. They stopped using isoflurane at the same time of 20 minutes before the surgery,propofol disabled after 5 minutes, immediately I.V. Flumazenil 0.5mg after the surgery. All patients in the two groups pulled out the endotracheal tube after recovering consciousness (calls reaction) and spontaneous breathing VT ＞ 92％, R ＞ 12/min, detached SpO2 ＞92％,respiratory defense reflection recovery and I.V. Neostigmin and atropine. Results Compared with the B group, before and after extubation and before induction in the A group there was no significant difference in SBP, DBP, MAP, and SpO2 (P ＞ 0. 05 ). Conclusion Improved extubation anesthesia technique can effectively reduce cardioascular response to surrounded extubation period, and revive quality improvement.