监护麻醉在鼻内窥镜鼻窦手术中的应用

目的探讨监护麻醉在鼻内窥镜鼻窦手术(FESS)中的应用。方法以芬太尼和咪达唑仑诱导,静脉泵注异丙酚维持。监测心率、呼吸频率、血氧饱和度、血压与脑电双频谱指数。结果手术出血量20～200ml,Ramsay镇静评分4～6级,术后清醒时间2～8分钟,术中BIS值60～80,有2例术中改全麻,术中术野清晰,可唤醒,术后恢复良好,全部患者无麻醉死亡。结论监护麻醉可满足FESS的麻醉要求,具有安全、苏醒迅速、术后并发症少的优点。

Applications of monitored anesthesia care during functional endoscopic sinus surgery

Objective To discuss applications of monitored anesthesia care during functional endoscopic sinus surgery. Methods Anesthetic induced with intravenous administration of fentanil and midazolam. Anesthetic maintenanced with infusion of propofol. The patients heart rate, respiratory rate, pulse oximetry, blood pressure and BIS were monitored. Results Blood loss was 20 - 200ml, Ramsay sedative grade was 4 - 6, awaking - time of postopration was 2 - 8 minutes. BIS was 60 - 80 during surgical procedures. General anesthesia was performed in 2 cases. There was a clear operation area and patients cottld be awaked during surgery procedures. All of patients recovered well. Conclusion Monitored anesthesia care can achieve the anesthetic aim of functional endoscopic sinus surgery. Monitored anesthesia care was provided with the advantages of satisfactory, awaking rapidly and less complications.