地氟醚紧闭循环麻醉临床应用  

The clinical application of anesthesia by closed-circuit of desflurane

作　　者：赵冬生 孟庆新 黄海斌 刘宣华 刘畅 明安绍 

机构地区：[1]武钢第一职工医院麻醉科,湖北武汉430080

出　　处：《中国冶金工业医学杂志》2001年第3期132-134,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的 :探讨地氟醚紧闭吸入麻醉的临床应用。方法 :以紧闭循环方式观察 78例ASAⅠ～Ⅲ级主要为上腹部手术病人。用Datex多功能监测仪持续监测病人 ,观察其血压、心率、心电、经皮氧饱和度及各种气体的变化。使用Dr gerSA2 型麻醉机及地氟醚专用挥发罐。麻醉维持期氧流量 0 8～ 1 5L/min。结果 :地氟醚吸入浓度MAC值 0 5～ 2 0时 ,脉率变化不明显 ,而收缩压和舒张压随浓度的增高而逐渐降低。停止麻醉后 ,当地氟醚浓度降至 0 1MAC以下时 ,平均 57秒钟恢复自主呼吸 ,2 0 8分钟拔出气管导管 ,4 1 6分钟睁眼 ,具有应答能力的平均时间为5 9分钟。结论 :地氟醚是一种苏醒快和性质稳定的麻醉剂 ,应用紧闭循环方式既安全又容易控制。Objective:To evaluate the clinical application of anesthesia by closed-circuit of desflurane.Methods:Seventy-eight patients (ASA Ⅰ～Ⅲ grade) mostly scheduled for epigastric surgery by desflurane closed circuit anesthesia.Datex Engstrom monitor with multiple functions was applied.The changes of BP,HR,EKG,SpO 2,the concentrations in recircuit of O 2 、CO 2 and desflurane were monitored.Five minutes before anesthesia was induced,fentanyl 2 μg/kg and droperidol 0 05～0 1 mg/kg had been droped intravenously.Anesthesia was induced with thiopentone and succinylcholine or vecuronium intravenously,then a cuffed endotracheal tube was performed,followed by inhalation of desflurane for Drger SA 2 anesthesia,machine and drger Devapor vaporizar.Anesthesia was maintained by using low flow of desflurane through closed circuit method.The mean surgery time was (133±74 5) min.The mean amount of desflurane was delivered by 37 3 ml/h in every case.Results:Desflurane inhaled concentration at 0 5～2 0 MAC,no significant changes occurred in HR,but systolic and distolic blood pressure gradually decreased as concentration increasing.There was significant statistical difference.After desflurane discontinued,the mean independence respiration recover time was 57 seconds,the mean extubation time was (2 08±1 3) min.The mean open eye time was (4 16± 2 01) min.The mean consciousness recovering time was (5 9±2 27) min.There were 2 cases complicated with nausea and 1 case with vomiting in post operation.Conclusions:The desflurane is an inhalation anesthetic with fast consciousness recovering speed and good stability.The desflurane closed circuit anesthesia is a safe and easily controlled method.

关 键 词：吸入麻醉 地氟醚 紧闭循环 临床应用 

分 类 号：R614[医药卫生—麻醉学]