不同氧流量对异氟醚吸入和呼出浓度的影响  

The Effect of Different Fresh Gas Flow on the Inspired and Expired Concentration of Isoflurane

作　　者：徐文庆[1] 徐威[1] 宫燕[1] 陈建军[1] 

机构地区：[1]复旦大学附属金山医院麻醉科,上海200540

出　　处：《中国临床医学》2011年第1期90-91,共2页Chinese Journal of Clinical Medicine

摘　　要：目的：研究半紧闭低流量麻醉时等量异氟醚不同氧流量对异氟醚吸入和呼出浓度的影响。方法：30例美国麻醉医师协会（ASA）评分Ⅰ~Ⅱ级静吸复合麻醉腹部手术患者随机分为A组和B组,每组15例,分别在新鲜气流量O20.6L/min时设定异氟醚挥发罐浓度（Fd）为5%和新鲜气流量O21L/min时设定异氟醚挥发罐浓度为3%,即每分钟向回路内输入30mL异氟醚气体。用Datex-Ohmeda S/5气体监测仪连续监测麻醉气体吸入浓度（Fi）、呼气末浓度（Fa）、呼气末二氧化碳分压（PETCO2）、吸入氧浓度,观察30min。结果：（1）2组异氟醚Fi和Fa上升缓慢,相同时间点Fi和FaA组显著高于B组（P〈0.05）。（2）A组异氟醚的Fa/Fi上升速率在12min内显著高于B组（P〈0.05）,随后逐渐接近。（3）A组异氟醚的Fi/Fd显著低于B组（P〈0.05）。结论：半紧闭低流量麻醉时向回路内输入等量的异氟醚,降低流量的同时提高挥发罐设定浓度,能达到较高的麻醉深度,该方法有一定的临床实用价值。Objective： To investigate the effect of different fresh gas flow（FGF） of same volume of isoflurane vapor on the inspired and expired concentration of isoflurane during partly closed circuit anesthesia.Methods：Thirty the American Society of Anesthesiologists physical function score（ASA）Ⅰ to Ⅱpatients were randomly divided into two groups（n=15 for each group）.In Group A,FGF was O20.6 L/min,the isoflurane dial setting（Fd） was 5%;Whereas in Group B,it was O21 L/min,the isoflurane dial setting was 3%.The patients had no heart,pulmonary,liver and kidney problems,and their demographic date were comparable.The patients were premeditated with lamina 0.1 g and atropine 0.5 mg intramascular injection.Anesthesia was induced with propofol 2 mg/kg,fentanyl 3 μg/kg and succinylcholine 2 mg/kg.After tracheal intubations the patients were mechanically ventilated to maintain PETCO2 between 4.5 to 5 kPa.The inspired concentration（Fi） and alveolar concentration（Fa） of isoflurane were recorded for 30 min.Results：（1） The Fi and Fa of isoflurane in Group A were higher than those in Group B（P0.05）.（2） The Fa/ Fi of isoflurane in Group A were higher than those in Group B at the beginning（P0.05）,but gradually approached.（3） Fi/Fd in Group A was lower than those in Group B（P0.05）.Conclusions： Delivering same volume of anesthetic vapor,the lower FGF produces higher anesthetic degree.The minimal flow anesthesia is safe and economical.

关 键 词：低流量麻醉 异氟醚 吸入浓度 

分 类 号：R614.2[医药卫生—麻醉学]