异氟醚-ZEUS循环紧闭麻醉患者苏醒期临床特征观察  

Observation of patients clinical characteristics during recovery period in low flow and circulation closed pattern anesthesia by ZEUS with isoflurane

作　　者：盛开花[1] 龚志毅[2] 陈雪华[1] 

机构地区：[1]北京潞河医院麻醉科,101149 [2]北京协和医院麻醉科

出　　处：《肿瘤研究与临床》2012年第8期537-539,共3页Cancer Research and Clinic

摘　　要：目的观察患者在异氟醚-ZEUS循环紧闭麻醉苏醒期的临床特征。方法选择35例美国麻醉师协会（ASA）分级Ⅰ或Ⅱ级在全身麻醉下择期行妇科手术的患者，应用ZEUS麻醉机的Autocontrol模式，吸入异氟醚-N2O-O2维持麻醉。记录异氟醚的吸入和呼出时间、睁眼时间，麻醉药的用量；记录在停药、自主呼吸恢复、呼之睁眼时的Narcotrend分级（NTS）、Narcotrend指数（NTI）、呼气末异氟醚浓度（EXP）、最低肺泡有效浓度（MAC）、血流动力学指标。术后随访有无术中知晓。结果与停药时相比，自主呼吸恢复、拔管时的血流动力学指标收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）变化显著[（108．1±13．4）mmHg（1mmHg=0．133kPa）、（66．3±12．1）mmHg、（84．3±12．5）mmHg、（69．8±12．5）次／min与（124．6±17．9）mmHg、（75．7±14．5）mmHg、（96．0±14．6）mmHg、（82．8±15．0）次／min与（128．0±16．3）mmHg、（77．1±15．0）mmHg、（99．8±15．3）mmHg、（85．2±18．5）次／min]（t=-4．365、-2．951、-3．574、-3．921；t=-5．554、-3．309、-4．642、-4．085，均P〈0．01）；NTI、EXP、MAC变化显著[50±7、（0．9±0．0）％、（1．2±0．1）％与74±12、（0．1±0．1）％、（0．2±0．2）％与（86±10）％、0、01（t=-9．382、z=-7．262、z=-7．186；t=-16．682、z=-7．835、z=-7．728，均P〈0．01）。术后随访无术中知晓。结论异氟醚适合ZEUS麻醉机低流量循环紧闭的麻醉方式，但患者意识恢复需要的时间长。Objective To explore the clinical characteristics of patients during recovery period in low flow and circulation closed pattern anesthesia by ZEUS with isoflurane. Methods During elective gynecologic surgery, 35 ASA Ⅰ or Ⅱ patients were anesthetized with isoflurane under general anesthesia with tracheal intubation. The ventilation was used with the closed circuit breathing mode （Autocontrol） of ZEUS anesthesia machine. The time of inhale drug, exhale drug and eyes-opend , consumption of＂ drug and complication were recorded during the process. The values of NT stage （NTS）, NT index （NTI）, the final endexpiratory concentration of isoflurane （EXP）, MAC and hemodynamic parameters were recorded during the time of isoflurane stopping inhale, recovery of spontaneous respiration, eyes opening. Results The values of NTI （50±7, 74±12, 86±10, t = -9.382, t = -16.682, P 〈 0.01）, the EXP [（0.9±0.0）%, （0.1±0.1）%, 0, z = -7.262, z =-7.835], MAC [（1.2±0.1）%, （0.2±0.2）%, 0, z =-7.186, z =-7.728, P 〈 0.01] and hemodynamic parameters （SBP, DBP, MAP, HR） [（108.1±13.4） mm Hg （1 mm Hg = 0.133 kPa）, （66.3±12.1） mm Hg, （84.3±12.5） mm Hg, （69.8±12.5） /min and （124.6±17.9） mm Hg, （75.7±14.5） mm Hg, （96.0±14.6） mm Hg, （82.8±15.0）/min and （128.0±16.3） mm Hg, （77.1±15.0） mm Hg, （99.8±15.3） mm Hg, （85.2±18.5） bpm] （t = -4.365, t = -2.951, t = -3.574, t = -3.921; t = -5.554, t = -3.309, t = -4.642, t = -4.085, P 〈0.01） during the time of recovery of spontaneous respiration and tracheal extubation were statistically significant compared to the time of isoflurane stopping （P〈 0.01）. None of patients experienced intraoperative was awareness. Conclusion Isoflurane can be used for closed circuit breathing mode of ZEUS anesthesia machine, but consciousness recovery need a long time.

关 键 词：ZEUS 麻醉 闭合循环 异氟醚 麻醉恢复期 

分 类 号：R614[医药卫生—麻醉学]