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丙泊酚全凭静脉麻醉与七氟醚吸入麻醉用于口腔颌面外科手术的术后特点比较。

Propofol based total intravenous anesthesia versus sevoflurane based inhalation anesthesia: The postoperative characteristics in oral and maxillofacial surgery.

机构信息

Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey.

Department of Oral & Maxillofacial Surgery-Anesthesiology, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey.

出版信息

J Craniomaxillofac Surg. 2020 Sep;48(9):880-884. doi: 10.1016/j.jcms.2020.07.002. Epub 2020 Jul 12.

Abstract

OBJECTIVE

Total intravenous anesthesia and inhalation/volatile anesthesia are the main general anesthesia procedures used in all surgical applications. The aim of this study was to compare sevoflurane anesthesia and total intravenous anesthesia with propofol in terms of postoperative complications, especially after oral and maxillofacial surgeries.

MATERIAL AND METHODS

Each patient was taken to the recovery room following extubation, and the pulse rate, non-invasive blood pressure (NIBP) and oxygen saturation were monitored. Presence of hypoxia, tachycardia, bradycardia, hypertension and hypotension were determined as vital sign complications.

RESULTS

The risk of complications related to vital functions were low for both anesthesia methods, and no statistically significant difference between the groups. The incidence of nausea and vomiting was found to be significantly higher in the patients undergoing both major (p = 0.011) and minor (p = 0.021) surgeries in the IA-S group. The recovery time was found to be significantly longer in the TIVA-P group compared to the IA-S group in the patients undergoing both major (p = 0.026) and minor surgery (p = 0.018).

CONCLUSION

TIVA and IA methods, which are considered safe in terms of vital signs, should be preferred according to patient characteristics. Despite the fact that inhaled anesthetics require PONV premedication for long term interventions, we believe that they could be preferred due to shorter recovery time compared to intravenous anesthetics.

摘要

目的

全凭静脉麻醉和吸入/挥发性麻醉是所有外科手术中主要使用的全身麻醉程序。本研究旨在比较七氟醚麻醉和依托咪酯全凭静脉麻醉在术后并发症方面的差异,特别是在口腔颌面外科手术后。

材料和方法

每位患者拔管后被送往恢复室,并监测脉搏率、无创血压(NIBP)和血氧饱和度。确定缺氧、心动过速、心动过缓、高血压和低血压是否为生命体征并发症。

结果

两种麻醉方法与生命功能相关的并发症风险均较低,组间无统计学差异。在接受主要手术(p=0.011)和次要手术(p=0.021)的患者中,IA-S 组的恶心和呕吐发生率明显更高。与 IA-S 组相比,在接受主要手术(p=0.026)和次要手术(p=0.018)的 TIVA-P 组患者中,恢复时间明显更长。

结论

从生命体征的角度来看,全凭静脉麻醉和吸入麻醉都被认为是安全的,应根据患者的特点来选择。尽管吸入麻醉需要进行 PONV 预防用药以进行长期干预,但我们认为与静脉麻醉相比,它们的恢复时间更短,因此可以优先考虑。

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