降血压麻醉在私人执业的功能性内窥镜鼻窦手术中的作用

IF 0.1 Q4 OTORHINOLARYNGOLOGY Bangladesh Journal of Otorhinolaryngology Pub Date : 2020-02-04 DOI:10.3329/bjo.v24i1.45328
Nurullah, A. H. Bhuyan, S. Islam, Shah Alam
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引用次数: 1

摘要

背景:功能性内窥镜鼻窦手术(FESS),有效控制出血是保持手术视野清晰和减少并发症的必要条件。术中出血是鼻窦内窥镜手术的主要问题之一。控制性低血压是一种用于限制术中失血量的技术,为手术提供最好的环境。目的:研究低血压麻醉在功能性内镜鼻窦手术中的作用,比较正常血压麻醉和低血压麻醉下术中出血和术野可见性。方法:前瞻性随机研究共纳入60例接受选择性FESS手术的ASA I-II患者。患者随机分为低血压组(A组)和正常血压组(B组)两组,记录术中平均动脉压(MAP)、心率(HR)。结果:A、B组患者平均年龄分别为33.36±7.61岁和32.46±7.73岁。各组间年龄差异在0.05水平上无统计学意义。各组患者麻醉前、术前平均心率及随访时间。5分钟、15分钟、30分钟、45分钟、60分钟心率组间差异有统计学意义。各组患者麻醉前平均动脉平均血压及不同随访期术前估计。5分钟、15分钟、30分钟、45分钟、60分钟组间差异有统计学意义。结论:硝酸甘油和拉贝他洛尔能同样有效地达到控制性低血压,显著减少术中出血,产生降压麻醉。在功能性内窥镜鼻窦手术(FESS)中,两者同样有效地提供理想的手术视野。
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Role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery in Private Practice
Background: Functional endoscopic sinus surgery (FESS), effective control of bleeding is essential to maintain a clear operative field and to minimize complications. Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objective: The objective of study was role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery and designed to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia. Methods: Prospective randomized study includes a total of 60 ASA I-II patients who underwent elective FESS surgery. Patients randomly assigned in two groups the hypotension group (Group A) and the normotension group (Group B). Intraoperative mean arterial pressure (MAP), heart rate (HR) were recorded. Results : This study shows the mean ages of the patients of group A group B were 33.36±7.61 and 32.46±7.73 years respectively. No statistically significant difference was observed among groups at 0.05 level in term of age. The mean heart rate pre-anaesthesia and preoperative among the patients of different groups in different follows up period. Significance differences were observed among groups in term of heart rate at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. The mean arterial mean blood pressure before pre-anaesthesia and preoperative estimation among the patients of different groups in different follows up period. Significance differences were observed among groups at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. Conclusion: This study demonstrated that Controlled hypotension can be achieved equally and effectively by nitroglycerin and labetalol reduced significantly intraoperative hemorrhage and produce hypotensive anesthesia. Both are equally effective in providing ideal surgical field during functional endoscopic sinus surgery (FESS).
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