七氟烷减量法对行腹腔镜下胆囊切除术患者苏醒时间的影响  

Effect of sevoflurane titration anesthesia on recovery time in bispectral index monitoring laparoscopic cholecystectomy

作　　者：李华[1] 孙波[1] 佘高明[1] 谢红[1] 王琛[1] 

机构地区：[1]苏州大学附属第二医院麻醉科,江苏苏州215004

出　　处：《上海医学》2012年第4期277-279,共3页Shanghai Medical Journal

摘　　要：目的观察七氟烷减量法对行腹腔镜下胆囊切除术患者苏醒时间的影响。方法 45例美国麻醉医师学会(ASA)分级Ⅰ～Ⅱ级、行择期腹腔镜胆囊切除术患者,随机分为3组,每组15例:Ⅰ组,皮肤缝合结束时停止吸入七氟烷,增加氧流量至10L/min;Ⅱ组,腹膜缝合结束时停止吸入七氟烷,增加氧流量至10L/min,静脉注射丙泊酚0.5mg/kg;Ⅲ组,关闭腹膜即刻,降低七氟烷浓度至0.5最低肺泡有效浓度(MAC),缝合皮肤结束时停止吸入七氟烷,增加氧流量至10L/min。观察苏醒时间(自皮肤缝合结束至患者接受指令睁开眼睛时间)、脑电双频指数(BIS)值达90的时间及生命体征监测指标[平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)和呼气末二氧化碳分压(petCO2)]。结果Ⅱ、Ⅲ组患者停止七氟烷吸入后的苏醒时间及BIS值恢复至90的时间均显著短于Ⅰ组(P值均<0.05),Ⅲ组又显著短于Ⅱ组(P值均<0.05)。3组在气管拔管前即刻各项生命体征(MAP、HR、petCO2及SpO2)的差异均无统计学意义(P值均>0.05)。结论腹腔镜下胆囊切除术麻醉苏醒阶段采用七氟烷逐步减量法,可减少联合药物使用的影响,缩短患者术后苏醒时间,并且不会影响麻醉后苏醒质量。Objective To study the effect of sevoflurane titration anesthesia on recovery time in bispectral index （BIS） monitoring laparoscopic cholecystectomy. Methods Forty-five patients （American Society of Anesthesiologists EASA-] I-Ⅱ level） underwent laparoscopic cholecystectomy and were randomly divided into 3 groups （n = 15）. The patients in group I stopped inhaling sevoflurane after skin closure and oxygen flow increased to 10 L/min. The patients in group Ⅱ stop inhaling sevoflurane after peritoneal suture, oxygen flow increased to 10 L/rain, and propofol （0. 5 mg/kg） was intravenously injected. For group m＇, sevoflurane decreased to 0.5 minimum alveolar concentration （MAC） at the end of peritoneal closure and was stopped after skin closure, and oxygen flow increased to 10 L/min. The recovery time （from finishing skin closure to opening eyes under orders）, the time of BIS being 90, and vital signs （mean arterial pressure [MAP], heart rate [HR], pulse, saturation of blood oxygen [SpO2], and carbon dioxide of end expiration 1-pet CO2 1） were recorded. Results The recovery time and the time of BIS being 90 in groups Ⅱ and were significantly shorter than those in group I （all P〈0.05）. The parameters in group Ⅲ were also significantly shorter than those in group （all P〈0.05）. But there were no statistical differences in the indicators of vital signs （MAP, FIR, petCO2 and SpO2 ） before extubation among groups （all P〉0.05）. Conclusion Sevoflurane titration anesthesia can reduce the impact of combined drug use, shorten the recovery time after surgery and keep the recovery quality in laparoscopic cholecvstectomv. （Shanohai Med J, 2012, 35.. 277-279）

关 键 词：七氟烷 胆囊切除术 腹腔镜 苏醒时间 

分 类 号：R614[医药卫生—麻醉学]