Tang Linghua, Liu Huimin, Wu Yang, Li Mei, Li Wei, Jiang Meng, Hou Jiabao, Jiang Ying, Xia Zhongyuan, Meng Qingtao
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China.
Exp Ther Med. 2017 Oct;14(4):3145-3152. doi: 10.3892/etm.2017.4919. Epub 2017 Aug 9.
The aim of the present study was to evaluate the safety and efficacy of various general anesthesia regimens during endoscopic variceal ligation (EVL) and endoscopic variceal sclerotherapy (EVS). A total of 123 patients with American Society of Anesthesiologists physical status III and IV, aged 40-70 years, undergoing general anesthesia for EVL and EVS were randomly divided into two groups: Sevoflurane anesthesia (group S; n=60) and propofol anesthesia (group P; n=60). Vital signs, particularly heart rate (HR) and mean arterial pressure (MAP), were monitored. The designated time points were as follows: 5 min before induction (T0), and 1, 5, 10, 15, 20, 25 and 30 min after intubation (T1, T2, T3, T4, T5, T6 and T7, respectively). Time intervals were recorded, including recovery time and extubation time. Following surgery, the observer recorded the Ramsay sedation scale (RSS) score and the visual analogue scale (VAS) score. Adverse reactions were noted. Results demonstrated that there were significant differences in MAP between the two groups at T2, T3, T5, T6 and T7 (P<0.05). There was a significant difference in HR between the two groups at T2, T3 and T4 (P<0.05). Recovery time and extubation time in group P were significantly longer than those in group S (P<0.05; 18.38±2.25 min vs. 14.57±1.04 min and 21.70±2.70 min vs. 15.83±0.88 min, respectively). The rate of ephedrine injected was 58.3% (35/60 patients) in group P vs. 28.3% (17/60 patients) in group S (P<0.05). There was a significant difference in the RSS score between the two groups 5 min after extubation (P<0.05). VRS scores demonstrated that anesthetists and patients were significantly more satisfied with the procedure in group S than in group P (P<0.01). In conclusion, the superiority and special clinical value of inhalational anesthesia has been demonstrated during EVL and EVS attributed to stable hemodynamics and high quality of anesthesia recovery in the present study.
本研究旨在评估内镜下静脉曲张结扎术（EVL）和内镜下静脉曲张硬化疗法（EVS）期间各种全身麻醉方案的安全性和有效性。共有123例年龄在40 - 70岁、美国麻醉医师协会身体状况为III级和IV级、接受EVL和EVS全身麻醉的患者被随机分为两组：七氟醚麻醉组（S组；n = 60）和丙泊酚麻醉组（P组；n = 60）。监测生命体征，尤其是心率（HR）和平均动脉压（MAP）。指定的时间点如下：诱导前5分钟（T0），以及插管后1、5、10、15、20、25和30分钟（分别为T1、T2、T3、T4、T5、T6和T7）。记录时间间隔，包括恢复时间和拔管时间。手术后，观察者记录Ramsay镇静评分（RSS）和视觉模拟评分（VAS）。记录不良反应。结果表明，两组在T2、T3、T5、T6和T7时MAP有显著差异（P<0.05）。两组在T2、T3和T4时HR有显著差异（P<0.05）。P组的恢复时间和拔管时间明显长于S组（P<0.05；分别为18.38±2.25分钟对14.57±1.04分钟和21.70±2.70分钟对15.83±0.88分钟）。P组麻黄碱注射率为58.3%（35/60例患者），S组为28.3%（17/60例患者）（P<0.05）。拔管后5分钟两组RSS评分有显著差异（P<0.05）。VRS评分显示，麻醉医生和患者对S组手术的满意度明显高于P组（P<0.01）。总之，本研究表明吸入麻醉在EVL和EVS期间具有优越性和特殊的临床价值，归因于其稳定的血流动力学和高质量的麻醉恢复。
