耳鼻咽喉科領域での全身麻酔手術—統計的検討ならびにその問題点

Otolaryngological Operations Under General Anesthesia

はじめに

　近年，麻酔学の進歩により全身麻酔下の手術が耳鼻咽喉科に限らず全科的に増加傾向にある。耳鼻咽喉科の手術での全身麻酔法は，吸入麻酔による気管内挿管法が絶対的適応となり，短時間の手術に対しては非挿管法のマスク法も行われている。しかし，吸入麻酔においては呼吸器，循環器の合併症，さらに，悪性高熱症といった重篤な合併症があり注意が必要である。そこで今回われわれは，当院耳鼻咽喉科で行った全身麻酔手術の統計的検討を行うとともに，全身麻酔手術の問題点について検討したので報告する。

Out of 2,549 surgical cases in our Department of Otolaryngology during a 5-year period between 1983 and 1987, the cases performed under general anesthesia increased from 191 (44.8%) in 1983 to 394 (63.2%) in 1987. Of the patients with tonsillectomy and adenotomy, 93.5% and 100% were performed under general anesthesia in 1983 and 1987, respectively, and 96~98% of those with nasal operation received local anesthesia. Inhala-tion anesthesia using the mask method was used for insertion of a tympanotomy tube in pediatric patients of otitis media with effusion.

Since operation under general anesthesia has some problems, surgery should be performed with close cooperation between anesthesiologists and otolaryngologists. Tracheal tubes are particularly troublesome since they come close to the operative field. The present study describes one patient associated with malignant hyperthermia.