喉罩七氟醚吸入麻醉对乳腺癌根治术患者血流动力学的影响  

Effect of sevoflurane anesthesia combined with with laryngeal mask airway on haemodynamics of the patients undergoing radical mastectomy

作　　者：陈轶菁[1] 沈华[1] 汪春英[2] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院麻醉科陈轶菁、沈华,200437 [2]上海市黄浦区中心医院麻醉科汪春英,200437

出　　处：《临床麻醉学杂志》2011年第5期452-454,共3页Journal of Clinical Anesthesiology

摘　　要：目的应用胸腔阻抗法监测喉罩七氟醚吸入麻醉对乳腺癌根治术患者血流动力学的影响。方法60例ASAI或Ⅱ级择期在全麻下实施乳腺癌根治术的患者，随机均分为七氟醚吸入组（I组）和丙泊酚静脉组（1I组）。观察两组诱导及清醒情况。在麻醉诱导前（To）、插入喉罩前（T1）、插入喉罩后即刻（T2）、切皮即刻（L）、拔除喉罩前（L）、拔除喉罩后即刻（]r5）记录SpO：、P盯C02、HR、MAP、每搏输出量（SV）、循环阻力（SVR）和加速指数（ACI）。结果两组清醒时间差异无统计学意义。与Tc时比较，T。、T2时I组MAP、SVR均降低（P〈o．05）；R时ACI明显下降（P〈O．05）；T1、T2时Ⅱ组HR减慢、MAP、SV、SVR均下降（P〈0．05）；T1～L时ACI均下降（P〈0．05）；T1、T2时Ⅱ组MAP、SV均低于I组（P〈0．05）；R时HR慢于I组（P〈O．05）；T，时ACI低于I组（P〈O．05）。结论七氟醚吸人麻醉用于乳腺癌根治术，血流动力学更趋稳定，手术期间可维持接近正常生理状态的心输出量和体循环阻力，全麻后苏醒平稳。Objective To investigate the effects of sevoflurane anesthesia combined with laryngeal mask on haemodynamics of patients in radical mammary by thoracic electrical impedance. Methods Sixty patients, ASA I or Ⅱ, scheduled for elective radical mastectomy were randomly divided into sevoflurane inhalation anesthesia group（group I, n= 30） and propofol intravenous anesthesia group（group Ⅱ, n= 30）. The status of anesthesia induction or recovery was observed. The following data were recorded and statistical analyzed, SpO2, PEr CO2, HR, MAP, SV, SVR and ACI at time points of before anesthesia induction（T2）, before laryngeal mask intubation（T1 ）, after laryngeal mask intubation immediately （T2）, skin incision （TO）, before laryngeal mask extubation （T4）, after laryngeal mask extubation immediately（Ts）. Results Recovery time wasn＇t significantly different in two groups. Compared with those at To, MAP or SVR at T1 or Tz were significantly lower in group I （P〈 0. 05） ; ACI at T2 was significantly lower than that of T0in group I（P〈 0.05） HR, MAP,SV, SVR at T1 or Toweresignificantly lower than those at To in group Ⅱ （P〈 0.05）; ACI at T1 ,T2 or T3 weresignificantly lower than that at To in group Ⅱ （P〈0.05） ; MAP,SV at T1 or Tz in group Ⅱ was significantly lower than those in group I（P〈 0. 05） ; HR at T2 in group Ⅱ was significantly lower than that in group I（P〈 0. 05）; ACI at T1 in group Ⅱ was significantly lower than that in group I （P〈0. 05）. Conclusion It provided more stabile haemodynamics, cardiac output and systemic vascular resistance approximated to normal condition and equable recovery in sevoflurane anesthesia with laryngeal mask airway.

关 键 词：全身麻醉 七氟醚 喉罩 血流动力学 乳癌根治术 

分 类 号：R614[医药卫生—麻醉学]