ABSTRACT
Os procedimentos cirúrgicos e cosmiátricos realizados pelos dermatologistas, tais como laser para epilação, remoção de tatuagem e rejuvenescimento, curetagem, eletrocoagulação, crioterapia, preenchimentos injetáveis, aplicação de toxina botulínica, escleroterapia, "peelings" químicos, entre outros, requerem muitas vezes o uso de anestésicos locais para o conforto do paciente. Tradicionalmente, o agente anestésico de escolha é a lidocaína injetável. Embora seja muito eficaz na produção de anestesia local total, a injeção causa dor. Há vários anestésicos tópicos disponíveis que podem aliviar o desconforto causado por esses procedimentos, sem a necessidade de injeções.
ABSTRACT
Objective:To discuss the influence of different ways of anesthesia for surgery of vocal cord under laryngomicrosurgery.Methods:Forty ASA Ⅰ～Ⅱ patients undergoing surgery of vocal cord were randomly divided into two groups:Group Ⅰ ( n =20) received topical anesthesia of larynopharynx with 2% lidocaine 2ml before general anesthesia.Group Ⅱ ( n =20) received general anesthesia with topical anesthesia. Anesthesia was induced with 2% propofol 1～2mg/kg and fentanyl 100?g followed by vocuronium 0.1 mg/kg.The small-diameter Fr 6.0 trachea tube was intubated nasally.The lungs were mechanically ventilated.Anesthesia depth was maintained with 2.0 MAC isoflurance and propofol infusion 1～2mg/kg or discontinuous fentanyl.Dexamethasone was given at end of the procedure.ECG,HR,BP,S PO 2,P ET CO 2,blood gas were monitored during intubation,extubation or the microlaryngoscopy.Results:Cardiovascular reactions in Group Ⅰ were significantly less than in Group Ⅱ during intubation,extubation or placed microlaryngoscopy,and no complications occured in two groups.Conclution:Compared with topical anesthesia general anesthesia is a better method for surgery of vocal cord under laryngomicrosurgery.It can significantly relieve of cardiovascular effect and complication.