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目的对比开胸食管癌手术患者在七氟烷与丙泊酚深麻醉下拔管时的血流动力学变化及并发症情况,为深麻醉下拔管提供依据。方法择期开胸食管癌手术患者40例ASA I或Ⅱ级。随机分为七氟烷组(A组)和丙泊酚(B组),每组20例。A组采用七氟烷复合瑞芬太尼全麻,术毕在七氟烷深麻醉下拔管;B组采用丙泊酚复合瑞芬太尼全麻,术毕在丙泊酚深麻醉下拔管。对A、B两组的各项指标进行观察,比如SpO_2、HR、DBP以及SBP等指标进行分析,同时观察手术时间等项目,并且对患者的术后症状进行讨论。结果 A组患者血压、心率在T5时明显高于B组,苏醒慢于B组,且有3例烦躁患者;两组均有多例舌后坠情况。结论开胸食管癌手术患者深麻醉下拔管可有效抑制拔管时心血管反应,保持血流动力学稳定,以丙泊酚效果更优,但应注意呼吸道管理。
Objective To compare the hemodynamic changes and complications of patients with esophageal cancer undergoing deep sevoflurane and propofol anesthesia during extubation. Methods Forty patients with ASA I or II underwent esophageal cancer surgery. Randomly divided into sevoflurane group (group A) and propofol (group B), 20 cases in each group. Group A was treated with sevoflurane combined with remifentanil and anesthetized with sevoflurane anesthesia. Group B was anesthetized with propofol and remifentanil, and anesthetized with propofol under deep anesthesia tube. The indicators of A and B groups were observed, such as SpO_2, HR, DBP and SBP indicators were analyzed, while the operation time and other items were observed, and the postoperative symptoms were discussed. Results The blood pressure and heart rate of patients in group A were significantly higher than those in group B at T5 and slower than those in group B, and there were 3 cases of irritable patients. There were many cases of tongue falling in both groups. Conclusions Extubation under deep anesthesia in patients undergoing thoracotomy for esophageal cancer can effectively restrain cardiovascular reactions during extubation and maintain hemodynamic stability. Propofol is more effective, but respiratory management should be paid attention to.