老年人经喉罩全凭七氟醚吸入用于 支气管镜检查的可行性

Feasibility of anesthesia of sevoflurane inhalation with laryngeal mask airway in elderly patients undergoing bronchoscopy examination

摘要:

目的 观察老年人经喉罩全凭七氟醚吸入在支气管镜检查术中的麻醉效果及安全性。 方法 30例择期行支气管镜检查老年人患者，年龄65～81岁，性别不限，ASA I～III级。经面罩全凭吸入七氟醚进行诱导，全凭七氟醚吸入维持，围手术期将麻醉深度指数（NI）维持在（40±10）范围内调整七氟醚呼气末浓度。记录麻醉诱导前（T1）、置入喉罩后即刻（T2）、支气管镜至声门（T3）、支气管镜至支气管（T4）、灌洗或活检（T5）、术毕去除喉罩时（T6）和去除喉罩后5 min（T7）时的MAP、SPO2、PETCO2、HR、NI、T2～T6时呼气末七氟醚浓度（CTsevo）、记录手术持续时间、麻醉时间、术毕至患者苏醒时间和术后读取七氟醚总用量。 结果 MAP、SPO2、PETCO2及HR7个时间点均值差异无显著性，NI在T2～T5与T1比较差异有显著性（P <0.05），CTsevo在T2～T5手术时间点均值差异无显著性，手术时间为（18.7±9.2） min，麻醉时间为（21.9±9.3） min，苏醒时间为（5.1±1.2）min，七氟醚平均用量为30.4 mL，30例老年患者均顺利完成手术操作。 结论 老年人经喉罩全凭七氟醚吸入麻醉可安全有效地应用于支气管镜检查术。

Abstract:

【Objective】 To observe the effect and safety of anesthesia of sevoflurane inhalation with laryngeal mask airway(LMA) in elderly patients undergoing bronchoscopy examination. 【Methods】 A total of 30 ASA physical status I-III patients(age 60~81 years old, Male or female) were scheduled to undergo general anesthesia for bronchoscope examination. Anesthesia was induced by mask inhalation of sevoflurane, and sevoflurane was inhaled for maintaining anesthesia. The end-tidal concentration of sevoflurane was adjusted according to narcotrend index (NI, NI were maintained in the range of 40±10) in peri-operation. The MAP, SpO2, PETCO2, HR, NI were recorded before the induction of anesthesia(T1), at the time of insertion of LMA (T2), the bronchoscope reached glottis (T3), reached bronchial tube (T4), during lavage or biopsy (T5), at the time of the removal of LMA (T6), after the removal of LMA (T7), and the end-tidal concentration of sevoflurane was recorded at the T2~T6 time points. The time of operation, anesthesia and awaking, and the volume of sevoflurane were recorded. 【Results】 MAP, SpO2, PETCO2 and HR were no significant differences in different time points (P >0.05), and there was significant different in NI at T2~T6 time points compared to T1 (P <0.05), there was no significant difference in CTsevo at T2~T6 time points(P >0.05). Operation time was (18.7±9.2) min, anesthesia time was (21.9±9.3) min, awaking time was (5.1±1.2) min, the average volume of sevoflurane was 30.4 mL. 【Conclusion】 Anesthesia of sevoflurane inhalation with laryngeal maskairway can be used safely and effectively in elderly patients undergoing bronchoscopy examination.