Aun C S, Houghton I T, So H Y, Van Hasselt C A, Oh T E
Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT.
Anaesth Intensive Care. 1990 Nov;18(4):497-503. doi: 10.1177/0310057X9001800415.
An anaesthetic technique for laryngeal microsurgery is described and evaluated using intravenous propofol infusion and topical lignocaine with the patient breathing spontaneously without an endotracheal tube. Eighty adult patients divided into two groups according to their ASA status (Group A; 58 ASA I and II; Group B; 22 ASA III and IV) were analysed. Operating conditions were good in all but one case. Good anaesthesia was achieved in about 70% of patients. The requirement for propofol was less in Group B. Blood pressures decreased significantly following induction (P less than 0.001) but returned towards the preoperative values after ten minutes in Group A patients whereas the recovery was slower in Group B. Apnoea occurred on induction in about 40% of patients overall. PaCO2 showed a similar small increase in both groups. Oxygenation was adequate. The results show that propofol as an infusion in this simple tubeless technique is satisfactory. As the technique was considered potentially hazardous in those patients with upper airway obstruction, such patients were not included in this study.
本文描述并评估了一种用于喉显微手术的麻醉技术，该技术采用静脉输注丙泊酚和局部应用利多卡因，患者自主呼吸，无需气管插管。将80例成年患者根据其美国麻醉医师协会（ASA）分级分为两组（A组；58例ASA I和II级；B组；22例ASA III和IV级）进行分析。除1例病例外，所有病例的手术条件均良好。约70%的患者实现了良好的麻醉效果。B组对丙泊酚的需求量较少。诱导后血压显著下降（P<0.001），但A组患者在10分钟后血压恢复至术前水平，而B组的恢复较慢。总体约40%的患者在诱导时出现呼吸暂停。两组的动脉血二氧化碳分压（PaCO2）均有类似的小幅升高。氧合充足。结果表明，在这种简单的无管技术中，丙泊酚作为输注用药是令人满意的。由于该技术被认为对上气道梗阻患者有潜在危险，因此本研究未纳入此类患者。
