七氟烷吸入麻醉在宫腔镜术中的应用  

The application of sevoflurane anesthesia in gynecologic hysteroscopy

作　　者：周昶碧[1] 郑细妹[1] 方丽珊[2] 陈建南[1] 

机构地区：[1]莆田学院附属医院麻醉科,莆田351100 [2]莆田学院附属医院妇产科,莆田351100

出　　处：《福建医药杂志》2010年第4期98-99,共2页Fujian Medical Journal

摘　　要：目的观察妇科宫腔镜手术患者单纯吸入七氟烷的麻醉效果及对循环系统的影响。方法 83例宫腔镜手术患者,随机分为两组,观察组55例,麻醉诱导为吸入6%～8%七氟烷,麻醉维持为吸入2%～3%七氟烷;对照组28例,麻醉诱导先予30 s内快速静注异丙酚2 mg/kg,待患者意识消失后行宫腔镜手术。观察麻醉诱导前、术中、术毕患者HR、BP、平均动脉压(MAP)、SpO_2、呼吸频率等指标,并记录睫毛反射消失时间、睁眼时间及不良反应等。结果组内比较:与麻醉诱导前相比,术中与术毕两组患者收缩压、MAP均下降,观察组HR升高,差异有统计学意义(P<0.05),而舒张压、SpO_2、呼吸频率均无明显变化。组间比较:术中两组患者收缩压、MAP及HR差异有统计学意义(P<0.05)。观察组与对照组麻醉诱导睫毛反射消失时间分别为:(63.1±7.1)s与(42.4±6.4)s,差异有统计学意义(P<0.05);睁眼时间分别为:(3.1±0.5)min与(1.9±0.4)min,差异有统计学意义(P<0.05);观察组诱导兴奋期1例出现咳嗽。两组术中均无心律失常、术后均无嗜睡等不良反应发生。结论七氟烷用于宫腔镜下手术麻醉,诱导和苏醒过程迅速,麻醉维持平稳,对呼吸循环影响小,不良反应少。Objective To observe the effect of sevoflurane anesthesia in patients with gynecologic hysteroscopy and the impact on the circulatory system. Methods Eighty-three patients were randomly divided into two groups. The observation group, a total of 55 patients, were inhaled 6%--8% sevoflurane for anesthesia induction. Then, anesthesia was maintained for the inhalation of 2%-3% sevoflurane. For the control group, 28 cases, the induction of anesthesia was delivered with intravenous injection of propofol 2 mg/kg in 30 s. Hysteroscopy were underwent when patients lost consciousness. All patients were assessed for HR, BP, mean arterial pressure （MAP）, oxygen saturation （SpO2） and respiratory rate （RR） in different time. Also, we recorded the loss of eyelash reflex time, eye opening time and the occurrence of side effects. Results Within groups, SBP and MAP decreased and HR only in observation group increased significantly （P〈0.05） during maintenance of anesthesia and after anesthesia when compared with before induction of anesthesia. However, diastolic blood pressure, SpO2 and RR did not significantly change. Between groups, there were significant differences for SBP, MAP and HR in surgery （P〈0.05）. The loss of eyelash reflex time was （63.1± 7.1） seconds in observation group while （42.4 ± 6.4） seconds in control group. Moreo- ver, the eye opening time was （3.1±0.5） min and （1.9±0.4） min, respectively. They all had significant differences between the two group （P〈0.05）. In observation group, one case had cough when anesthesia induction were delivered. For both groups, no obvious side effects were found during or after surgery. Conclusion Sevoflurane anesthesia for gynecologic hysteroscopy has the advantage of rapid induction and recovery, smoothness in maintenance of anesthesia, little effect on respiration and circulation and less adverse reaction.

关 键 词：醚类 二异丙酚 麻醉 宫腔镜检查 

分 类 号：R614[医药卫生—麻醉学] R713[医药卫生—外科学]