Anaesthesia in endoscopic sinus surgery
Anaesthesia in endoscopic sinus surgery
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DOI：
10.1007/s00405-003-0613-z
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发表时间：
2003-10-01
影响因子：
2.6
通讯作者：
Olofsson, J
中科院分区：
文献类型：
--
作者：
Danielsen, A;Gravningsbråten, R;Olofsson, J
本研究的目的是评价1,460例(女性677例，男性783例)患者的麻醉方法，这些患者年龄4~79岁，在1987-2001年间由一位外科医生(AD)连续使用功能性鼻内窥镜入路(FESS)或鼻内窥镜入路(ESS)进行手术。纳入的患者表现出鼻腔和鼻窦内的各种疾病。许多患者患有鼻息肉样病变，这种疾病多年来逐渐扩大，对邻近结构造成压力。有几个人之前接受了多次手术，改变了原始的解剖结构。然而，大多数患者曾因急性复发和/或慢性感染而接受手术治疗，其他患者则因鼻源性头痛、良性肿瘤/粘液囊肿和嗅觉障碍而接受手术治疗。研究所使用的麻醉程序的目的是为了澄清不同外科任务对不同麻醉方法的需求。为了获得最佳的手术效果，患者和外科医生在手术中都感到绝对舒适是至关重要的。局部麻醉可以用于选定患者的小手术，甚至对正在接受培训的住院医生来说也是绝对合适的。在大多数情况下，病人和外科医生都倾向于全身麻醉。这篇文章的结论是，至少在我们的经验中，全静脉麻醉(TIVA)加上通过喉罩(LMA)的富氧空气(LMA)应该是首选的麻醉程序。
The aim of this study was to evaluate the methods of anaesthesia used in 1,460 patients (677 females and 783 males), aged 4 to 79 years, who were consecutively operated on with a functional endonasal endoscopic approach (FESS) or by an endoscopic endonasal approach (ESS) by one surgeon (AD) in the period from 1987-2001. The included patients presented a variety of disorders within the nose and sinuses. Many of the patients had sinonasal polypoid disease, which had gradually expanded over years and was causing pressure to neighbouring structures. Several had undergone previous multiple surgical procedures altering the original anatomy. However, the majority of the patients had been treated surgically for acute recurrent and/or chronic infections, others for sinogenic headache, benign tumours/mucoceles and smell disorders. The intention of looking into the anaesthetic procedures being used was to clarify the needs for a differentiated anaesthetic approach to different surgical tasks. It is of crucial importance for an optimal surgical result that both the patient and surgeon feel absolutely comfortable during the operation. Local anaesthesia can be used in minor surgery on selected patients and is definitely suitable even for residents in training. General anaesthesia is preferred in most cases by both patients and surgeons. The conclusion of this paper is that total intravenous anaesthesia (TIVA) in addition to oxygen-enriched air through a laryngeal mask airway (LMA) should be the anaesthetic procedure of choice, at least in our experience.