不同浓度七氟醚吸入对患者镇静程度和麻醉深度的影响  

The effects of different inhalational induction concentration with sevoflurane on the depth of sedation and anesthesia of patients

作　　者：程傲冰[1] 佘守章[1] 王淼[1] 许立新[1] 刘继云[1] 闫焱[1] 索琨[1] 

机构地区：[1]广州医学院附属市一人民医院麻醉科,510180

出　　处：《现代临床医学生物工程学杂志》2006年第4期324-327,共4页Journal of Modern Clinical Medical Bioengineering

基　　金：广东省医学科学技术研究基金项目(A2002573)

摘　　要：目的研究吸入不同浓度七氟醚全麻诱导对患者镇静程度和麻醉深度的影响。方法选择本院60例择期行妇科腹腔镜手术的患者(ASAⅠ-Ⅱ级),采用随机双盲对照方法,研究比较3组患者吸入七氟醚4%(A组)、6%(B组)和8%(C组)浓度的诱导时间、诱导质量、镇静程度和麻醉深度的差异。并记录睫毛反射消失时间、患者入睡时间、不良事件发生率,同时记录患者的平均动脉压(MAP)、心率(HR)、脑电双频谱指数(B IS)、听觉诱发电位指数(AAI)和警觉与镇静评分(OAA/S评分)。结果C组睫毛反射消失时间为(45.5±4.4)s要明显短于A组(78.1±8.3)s和B组(55.2±6.9)s(P<0.05),患者入睡时间C组(93.0±10.7)s也明显快于A组(148.4±13.8)s和B组(102.0±8.9)s(P<0.05)。OAA/S评分为3分时,C组的B IS值为(74.1±3.8),AAI值为(37.2±4.2);C组诱导前后MAP下降和HR增快,且部分患者波动较大(P<0.05)。C组呼吸暂停发生率(30%)要高于A组和B组(P<0.05)。结论单纯吸入七氟醚诱导患者入睡快,临床推荐吸入浓度为6%,其可提供良好的麻醉质量,且血流动力学平稳,不良反应小。Objective To investigate the effects of inhalational sevoflurane on the depth of sedation and anesthesia of patients during general anesthesia induction in gynecologic laparoscopic surgery. Methods A randomized double blind study was undertaken to assess the effects of different inhalational sevoflurane concentration on the time and quality of induction, the depth of sedation and anesthesia. Sixty patients undergoing gynecologic laparoscopic surgery （ASA Ⅰ-Ⅱ ） were divided into three groups. Group A： inhalated 4% sevoflurane ; group B - inhalated 6% sevoflurane ; group C ： inhalated 8% sevoflurane. Time to loss of eyelash reflex,time to fall asleep, incidence of adverse events, mean arterial pressure（MAP） , heart rate （HR） , bispectrial index （ BIS ）, A-line ARX index （ AAI ） and observer ＂s assessment of ahertness/ sedation（OAA/S） scale were recorded. Results The time to loss of eyelash reflex in group C（45.5 ± 4.4 ） s was significantly shorter than that in grosup A （78.1 ± 8.3 ）s and group B （55.2 ± 6. 9 ）s, and the time to fall asleep in group C（93.0 ± 10.7 ）s was also significantly less than that in group A（ 148.4 ± 13.8 ）s and group B （ 102.0 ± 8.8 ） s. When OAA/S scale was 3, the corresponding BIS and AAI value in group C approached to （74.1 ± 3.8 ） and （ 37.2 ± 4.2 ） , respectively. After inhalation induction, MAP decreased and HR increased from baseline（ P 〈0.05 ） in group C. Incidence of apnea in group C（ 30% ） was also higher than that in group A and group B. （ P 〈 0. 05 ）. Conclusion Induction with sevoflurane makes patients fall into sleep fast, and the rational inbalational concentration is 6% , it can also afford good anesthesia quality with a stable cardiovascular profile and little incidence of adverse events.

关 键 词：麻醉 吸入 七氟醚 麻醉深度 镇静 

分 类 号：R614[医药卫生—麻醉学]