七氟烷复合麻醉在腹腔镜手术中对循环功能的影响  

Influence of the Combination Aanethesia with Sevoflurane on Circulatory Function in Laparoscopic Operation

作　　者：陆建军[1] 何之学[1] 

机构地区：[1]东南大学附属江阴人民医院,江苏江阴214000

出　　处：《湖北民族学院学报（医学版）》2008年第2期39-41,共3页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨七氟烷复合麻醉在腹腔镜手术中对心率及平均动脉压的影响。方法ASAⅠ-Ⅱ级拟行腹腔镜手术患者90例,随机分为3组,七氟烷组（Ⅰ组）、七氟烷与瑞芬太尼复合麻醉组（Ⅱ组）、对照组。观察手术前及手术进程中各时点的HR及MAP。结果对照组插管后HR比入室后显著升高（P〈0.01）,切皮后、气腹后HR比入室后明显升高（P〈0.05）,Ⅰ组插管后、气腹后HR较入室后均明显升高（P〈0.05）;Ⅱ组则无明显变化。Ⅱ组HR在插管后、气腹后时点均明显低于对照组（P〈0.05）,气腹后Ⅰ组Ⅱ组之间比较也有明显差异（P〈0.05）,对照组插管后MAP比入室时显著升高（P〈0.05）;气腹后Ⅰ组Ⅱ组MAP与入室后相比有明显差异（P〈0.05）,两组与对照组相比有均显著性差异（P〈0.05）。结论单纯七氟烷麻醉及七氟烷复合麻醉均能有效抑制腹腔镜手术中的不良应激反应。二者相较,七氟烷与瑞芬太尼复合麻醉具有更良好的血流动力学稳定性,因而优于单纯七氟烷麻醉。Objective To discuss the influence of the combined anesthesia with sevoflurane on circulatory function in laparoscopic operation. Methods 90 patients ranked Ⅰ to Ⅱ,who were supposed to carry out laparoscopic operation,were randomly divided into 3 groups,the Sevoflurane group（groupⅠ）,the Sevoflurane and Remifentanil group（group Ⅱ） and the control group.The heart rate and mean arterial pressure at different time point before operation and in the process of operation in group Ⅰ and Ⅱ were observed.Results In the control group,the heart rate at the time points of T2,T4 and T5 was significantly superior to that of T1（P〈0.05）.There was no significant difference in heat rate change of the group Ⅱ.The heart rate at the time points of T2 and T5 in group Ⅰ was significantly higher than that of T1（P〈0.05）.The heart rate at the time points of T2 and T5 in group Ⅱ was significantly lower than that in the control group（P〈0.01）.There was very significant difference in the heat rate at the time point of T5 between group Ⅰ and Ⅱ（P〈0.01）.The mean arterial pressure at the time point of T2 in the control group was significantly higher than that of T1（P〈0.05）.Compared to the control group,there was very significant difference in the mean arterial pressure at the time point of T5 in group Ⅰ and Ⅱ（P〈0.01）.Conclusion The simple anesthesia or combined anesthesia with sevoflurane can suppress effectively distress reaction in laparoscopic operation,and the effect of the combined anesthesia with sevoflurane and remifentanil which has better haemodynamic stability is better than that of the simple anesthesia with sevoflurane.

关 键 词：七氟烷 瑞芬太尼 腹腔镜 循环 

分 类 号：R614.2[医药卫生—麻醉学]