七氟烷吸入预防阑尾牵拉反应的临床观察  

Sevoflurane to Prevent the Clinical Observation of Traction Reaction Appendix

作　　者：李查兵[1] 

机构地区：[1]安徽省立友谊医院麻醉科,安徽合肥230034

出　　处：《中国医药指南》2011年第16期53-54,共2页Guide of China Medicine

摘　　要：目的对七氟烷吸入预防阑尾牵拉反应进行临床观察。方法选取安徽省立友谊医院阑尾手术40例,男24例,女16例,ASA分级Ⅰ~Ⅱ级,年龄18~55岁,将患者随机分成A、B两组,每组20例。硬膜外给药均为1%利多卡因＋0.25%丁卡因,A组在切开腹膜前面罩吸入七氟烷,B组在手术开始后给予咪达唑仑和芬太尼,如术中有牵拉反应再次给予。观察两组在T1、T2、T3、T4、T5不同时期的血压、心率变化和牵拉反应,并在术毕进行Ramsay镇静评分。结果 A组患者吸入七氟烷后血压、心率均有一定程度的下降,在牵拉切除阑尾时血压心率均无明显波动。B组患者在牵拉切除阑尾时血压心率波动变化明显,部分患者牵拉反应严重需要再次给药才能缓解牵拉反应。术毕即刻Ramsay镇静评分,A组均为0分,B组在2~5分之间。结论七氟烷应用于阑尾手术,具有麻醉诱导起效快,术中麻醉深度安全可控性好,牵拉反应等不良反应小,苏醒快等优点,值得推广。Objective Prevention of sevoflurane clinical observation of traction reaction appendix.Methods 40 patients in Anhui provincial friendship hospital from appendix surgery,24 males and 16 females,ASA grade Ⅰ ~ Ⅱ,aged 18-55 years,patients were randomly divided into A,B group,20 cases each.Epidural 1% lidocaine and 0.25% are tetracaine,A group preperitoneal incision sevoflurane mask inhalation,B group after the start of the operation given midazolam and fentanyl,such as surgery once again giving a stretch in response.Were observed in T1,T2,T3,T4,T5 different periods of blood pressure,heart rate and stretch response,and the Ramsay sedation score of surgery.Results A group of patients after sevoflurane inhalation of blood pressure,heart rate had decreased to some extent,in the stretch to remove the appendix had no significant heart rate,blood pressure fluctuations.Group B patients in traction to remove the appendix of heart rate fluctuation of blood pressure significantly,traction reaction in some patients can alleviate the serious need to re-administration of traction response.Ramsay sedation score of surgery immediately,A group were 0,B group between 2-5 minutes.Conclusion Sevoflurane used in appendix surgery,with a rapid onset of anesthesia,surgery safe and controlled depth of anesthesia and good traction reaction side effects,rapid recovery,etc.,are worth promoting.

关 键 词：七氟烷 阑尾牵拉反应 临床观察 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]