摘要
目的比较七氟醚和异氟醚低流量麻醉用于腹腔镜胆囊摘除术时药代动力学、苏醒过程以及不良反应。方法48例ASAⅠ～Ⅱ级择期腹腔镜胆囊切除术病人随机分成七氟醚组(S组)和异氟醚组(I组)。麻醉诱导插管后连接Drager麻醉机,S组吸入七氟醚/O2,挥发罐浓度(Fv)1.2～1.8MAC(2～3%);I组吸入异氟醚/O2,Fv2.2～2.6MAC(2.5%～3%)。术中用麻醉气体监护仪连续监测吸入气浓度(F1)、肺泡气浓度(FA)以及F1O2、PETCO2、MAP、HR。记录肺泡气浓度上升速率(FA/FI)、肺清除率(FA/FAO),诱导期FA/F1=0.5的时间,苏醒期FA/FAO=0.5的时间,术毕观察病人苏醒时间、有无苏醒期躁动。术后随访术中知晓、恶心呕吐及对麻醉的满意度。结果两组患者麻醉后至气腹前MAP、HR偏低,气腹时略有升高,两组间无显著差异。FA/F1=0.5的时间S组较I组短(P<0.01)。S组FA/F1比值较I组高,上升速度较I组快,FA/FAO降低速度1分钟内较I组快(P<0.05)。术后苏醒期躁动和恶心呕吐发生率S组低于I组。结论七氟醚麻醉诱导快,苏醒期平稳,术后恶心呕吐发生率低。
Objective To compare the pharmacokinetics, emergence process and adverse efferts among sevoflurane and isoflurane in low-flow anesthesia for laparoscopic cholecyctectomy. Methods Twenty-four ASA Ⅰ～Ⅱ patients were randomly divided into two groups： sevoflurane （group S, n=24）, isoflurane （group I, n=24）. Anesthesia was induced with intravenous propofol 1 mg/kg and maintained with sevoflurane or isoflurane. Graduation of volatile pot was 2%-3% for sevoflurane, 2.5%-3% for isoflurane. Cardiovascular responses, emergence profile and recovery characteristics were investigated. Results MAP and HR was on the low side in both groups after anesthesia induction and were lightly high at the time of surgery beginning. FA/FI=0.5 time was significantly shorter in S group than that in I （P〈0.05）. Falling-speed for FA/FAO was faster in S group than that in I in one minute （P〈0.05）. Restlessness in emergence process and postoperatinn nausea and vomiting was lower in S group than that in I. Conclusion Anesthesia has been induced with sevoflurane was faster. Emergence process was calmer for sevoflurane and it was associated with a lower incidence of postoperation nausea and vomiting.
出处
《当代医学》
2009年第30期155-156,共2页
Contemporary Medicine
关键词
七氟醚
异氟醚
全身麻醉
比较
Sevoflurane
Isoflurane
General anesthesia
Comparision
