极低流量安氟醚吸入麻醉的临床观察  

Even low-flow inhalation anesthesia of enflurane:a clinical study

作　　者：王高华 于文艳 邹义萍 林建平 李建生 李璟 

机构地区：[1]解放军513医院麻醉科,甘肃兰州732750

出　　处：《总装备部医学学报》2010年第3期144-146,共3页Medical Journal of General Equipment Headquarters

摘　　要：目的探讨极低流量安氟醚吸入麻醉的安全性与可靠性。方法选择ASAⅠ-Ⅱ、择期行腹部手术200例,随机分为A、B、C、D四组,每组各50例。A组和C组单纯吸入安氟醚维持麻醉,B组和D组行相应节段硬膜外阻滞麻醉加安氟醚吸入全身麻醉;维持期氧流量A组和B组为(0.1+MV/20)L/min,C组和D组以3 L/min流量吸入。所有患者均常规术前用药、麻醉诱导及气管插管后,先以3 L/min流量吸入安氟醚5 min,A组和B组改为最低流量维持,流量(0.1+MV/20)ml/min;C组和D组仍以3 L/min维持以作对照。麻醉采用OHMEDA 110全身麻醉机及OHME-DA蒸发器。记录麻醉中蒸发器刻度(Co)、安氟醚吸入浓度(Ci)及Ci/Co值的变化。结果全部患者均麻醉平稳;各组Co值分别为A组(4.62±0.27)%、B组(2.84±0.12)%、C组(2.49±0.16)%和D组(1.54±0.15)%,四组间比较具有显著性差异(t=42.49~70.47,P【0.01);Ci值A组与C组比较、B组与D组比较均无显著性差异(分别为t=0.538t、=0.561,P】0.05);Ci/Co值A组与B组比较、C组与D组比较均无显著性差异(t=1.256t、=2.444,P】0.05)。结论极低流量安氟醚吸入维持麻醉安全、可靠,但蒸发器刻度应为正常流量的2倍左右。Objective To evaluate the safety and efficacy of inhalation of enflurane for even low-flow anesthesia.Methods Three hundred adult ASA grades I and II patients,scheduled for abdominal operation,were randomly divided into four groups: group A(n=50),group B(n=150),group C(n=50) and group D(n=50).Inhalation anesthesia was conducted in groups A and C.Combined inhalation anesthesia with epidural block was used in groups B and D.Anesthesia was induced with rhythim 0.1 mg/kg,fentanyl 2μg/kg,propofol(1.5~2.0) mg/kg and vecuronium 0.12 mg/kg After intubation,anesthesia was maintained with enflurane at oxygen flow rate of(0.1+MV/20)L/min in groups A and B,and of 3L/min in groups C and D,respectively.The inspired concentration of enflurane(Ci),the vaporizer output concention(Co) and the rate of Ci/Co were recorded after 120 min of inhalation anesthesia.Results The Co,Ci and the rate of Ci/Co were stable after 1h of inhalation;there were significant differences in Co among the four groups,the Co in group A or B was doubled,as compared with those of control group;there were no differences in Ci between the groups A and C,and so were in Co between the groups B and D;there were significant differences in Ci between the group A or C and group B or D;there were no differences in Ci/Co between the groups A and B,and so were in Co between the groups C and D;there were significant differences in Ci/Co between the group A or B and group C or D.Conclusion The even low-flow enflurane anesthesia is safe and economical.But the Co has been doubled.

关 键 词：麻醉 闭合循环 安氟醚 吸入浓度 蒸发器 

分 类 号：R614.21[医药卫生—麻醉学]