丙泊酚和七氟醚全麻喉罩通气在妇科腹腔镜手术中的应用比较  

Comparison on the anesthetic effect of sevoflurane and propofol in ventilation with ProSeal laryngeal mask airway during gynecologic laparoscopy.

作　　者：李荣胜[1] 廖永强[1] 蓝晓文[1] 韩琪[1] 谢华杰[1] 周德清[1] 王彩霞[1] 

机构地区：[1]东莞市人民医院麻醉科,广东东莞523059

出　　处：《海南医学》2012年第24期7-8,共2页Hainan Medical Journal

基　　金：东莞市医疗卫生科技计划一般立项项目(编号:201010515000069)

摘　　要：目的比较妇科腹腔镜手术中ProSeal喉罩(PLMA)通气时吸入七氟醚与静脉丙泊酚麻醉的临床麻醉效果。方法选择妇科择期腹腔镜手术患者40例,随机分为静脉丙泊酚组(P组)和吸入七氟醚组(S组)各20例。全麻诱导依次静注芬太尼2μg/kg,P组静注丙泊酚2～2.5mg/kg,S组吸入5%七氟醚,患者入睡后静注阿曲库铵0.6mg/kg。置入PLMA后行机械通气。监测记录患者血流动力学及呼吸通气参数及不良反应。结果两组患者呼吸通气参数差异无统计学意义(P>0.05)。在诱导给药后,两组患者SBP、DBP、HR较基础值均下降(P<0.01),其中P组DBP和HR比S组更低(P<0.05或P<0.01),其余时点,两组患者血流动力学参数差异无统计学意义(P>0.05)。两组苏醒时间及不良反应发生率差异无统计学意义(P>0.05)。结论七氟醚和丙泊酚均可安全有效地用于腹腔镜手术全麻,起效和苏醒均迅速;相比于丙泊酚,七氟醚诱导期血流动力学较为平稳。Objective To compare the clinical efficacy of Sevoflurane and Propofol in ventilation with ProSeal laryngeal mask airway during gynecologic laparoscopy. Methods Forty ASA I or I1 patients undergoing gynecologic laparoscopy were divided randomly into group P （received propofol intravenous anesthesia） and group S （received sevoflurane inhalation anesthesia）, respectively, with 20 patients in each group. Anesthesia was induced and maintained with propofol or sevoflurane, combined with fentanyl, remifentanil and atracunium. The hemodynamics and characteristics of ventilation were monitored, and adverse reactions were recorded. Results There were no statistically significant differences between group P and group S in PetCO2, Peak, Compliance, recovery time, and the incidence of ad- verse reactions. Values of SBP, DBP, HR in the two groups were declined significantly during induction of anesthesia （P〈 0.01）, DBP and HR were significantly lower in group P than those in group S （P〈0.05 or P〈0.01）. Conclusion Both pro- pofol and sevoflurane can induce and maintain effective anesthesia during gynecologic laparoscopy. Compared with propofol, sevoflurane may result in more stable hemodynamics in the induction period of anesthesia.

关 键 词：妇科 腹腔镜手术 喉罩 丙泊酚 七氟醚 

分 类 号：R713[医药卫生—妇产科学]