姜珍华
JIANG Zhenhua

• 1:双流县第二人民医院麻醉科

摘要(Abstract)：

目的:探讨临床深麻醉拨管在神经外科手术麻醉中的有效性和安全性。方法:选择全麻插管下行神经外科手术的患者120例,随机分为对照组和观察组各60例,对照组患者清醒拔管,观察组在肌松药作用消除及患者有满意自主呼吸频率及潮气量下,于麻醉状态下拔管,比较两组T1(拔管前、拔管后即刻)和T2(拔管后1 min、2 min、5 min)血压、心率、并发症以及麻醉舒适度指标。结果:观察组拔管后不同时间段心率及平均动脉压均明显低于对照组(P<0.05),观察组T1、T2期间血氧饱和度<95%,呛咳、躁动、喉痉挛、支气管痉挛发生率显著低于对照组(P<0.01),观察组麻醉舒适度(100%)显著优于对照组(P<0.01)。结论:深麻醉下拔管可有效防止应激反应,预防浅麻醉下拔管引起的喉痉挛及支气管痉挛,提高患者麻醉舒适度,安全可行。
Objective: To explore the efficacy and safety of deep anesthesia extubation in neurosurgery anesthesia. Methods: One hundred and twenty patients of nerve surgery under general anesthesia with intubation were selected and randomly divided into control group and observation group with 60 cases in each group. Control group patients were extubated in awaking state,while observation group patients were extubated in anesthesia under the conditions that the muscle relaxant effect was eliminated and the patients had satisfactory spontaneous respiratory frequency and tidal volume. The blood pressure,heart rate,complications,anesthesia comfort were compared between control group and observation group. Results: The heart rate and mean arterial pressure at different time intervals in observation group were significantly lower than those in control group( P < 0. 05). The degrees of blood oxygen saturation( Sp O2) in T1 and T2 periods were less than 95%. The incidences of bucking,restlessness,laryngospasm,and bronchospasm in observation group were significantly lower than those in control group( P < 0. 01). Anesthesia comfort( 100%) in observation group was significantly higher than that in control group( P < 0. 01). Conclusion: Deep anesthesia extubation is safe and feasible,which can effectively prevent stress response,laryngospasm,and bronchospasm caused by superficial anesthesia extubation,and improve anesthesia comfort.

关键词(KeyWords)： 深麻醉下拔管;神经外科;舒适度;可行性
deep anesthesia extubation;neurosurgery;comfort;feasibility

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 姜珍华
JIANG Zhenhua

DOI: 10.19367/j.cnki.1000-2707.2015.01.024

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