The Clinical Study Of Airway Topical Anesthesia Combine With Genral Anesthesia During Suspension Laryngoscope Surgery

Objective:To research the effects of airway topical anesthesia combine with general anesthesia on suspension laryngoscope surgery.Methods:40 cases of elective suspension laryngoscope surgery,including resection of polyp of vocal cord and epiglottic cyst,hypopharyngeal tumor biopsy etc.The patients with difficult airway at the preoperative evaluation would be excluded.Aged 18-60 years.Gender unlimited.ASA I-II.Operation time least 30min.Randomly divided into 2 groups(n=20):experience group(E groupO and control group(C group).Anesthesia induction:target-controlled infusion of propofol(target plasma concentration 3.0ug/ml)and remifentanil(target plasma concentration 3.0ng/ml).After they slept and eyelash reflex disappeared,0.2mg/kg cisatracurium will be given.After the muscle relaxant onset,the E group patients would be given airway topical anesthesia with 2%lidocaine during exposing the glottis,and then lmin mask oxygen,and tracheal intubation following.After the muscle relaxant onset,the C group accepted tracheal intubation directly without airway topical anesthesia.Maintenance of anesthesia:all patients would be given 0.1 mg fentanyl and plasma target concentration of propofol and remifentanil would be turn to 3.0ug/ml and 3.0ng/ml before 1min of operation.If the arterial pressure beyond 140/90mmHg during operation,2%-3%sevoflurane would be added to the patient.The observation index:the systolic pressure,the diastolic pressure,the mean arterial pressure and heart rate at T0(before the anesthesia)?T1(before tracheal intubation)?T2(after 1min of tracheal intubation)?T3(before the suspension laryngoscope insertion)?T4(after 1min of the suspension laryngoscope insertion)?T5(after 3min of the suspension laryngoscope insertion)?T6(when the pressure was highest)will be record.At last record the cases witch use sevoflurane.Result:The general data was no statistically significant difference between the two groups(P>0.05).Comparison of the measurement data between the two groups:there were no statistical significant difference of the SP,the DP,the HR and MAP before anesthesia induction(T0),tracheal intubation(T1)and suspension laryngoscope insertion(T3).The SP,DP,MAP and HR in E group was lower than in C group(P<0.05)at T2,T4,T5,T6.The cases using sevoflurane in E group was less than in C group.Conclusion:Airway topical anesthesia combined with general anesthesia was effectively to reduce the cardiovascular response during suspension laryngoscope surgery.And it reduced the dose of general anesthetics.