不同孕酮浓度对手术切皮时七氟醚最低肺泡有效浓度的影响  

Effects of different progesterone levels on minimum alveolar concentration of sevoflurane inhalation anesthesia during skin incision

作　　者：谭美云[1] 张春元[1] 曾伟[1] 刘克玄[2] TAN Meiyun;ZHANG Chunyuan;ZENG Wei;LIU Kexuan(Department of Anesthesiology,Bo ai Hospital of Zhongshan,Zhongshan 528400,China)

机构地区：[1]中山市博爱医院麻醉科,广东省528400 [2]南方医科大学南方医院麻醉科

出　　处：《临床麻醉学杂志》2021年第12期1242-1245,共4页Journal of Clinical Anesthesiology

基　　金：中山市科技局立项(2019J181)。

摘　　要：目的探讨女性生理周期中不同孕酮浓度对手术切皮时七氟醚最低肺泡有效浓度(MAC)及用量的影响。方法选择2019年6月至2020年12月拟行妇科腹腔镜手术的患者46例,年龄20~40岁,BMI 18~24 kg/m^(2),ASA I或Ⅱ级。按生理周期将患者分为两组:卵泡期(L组,n=22)和黄体期(H组,n=24)。在Narcotrend监测下两组均采用七氟醚复合瑞芬太尼进行麻醉诱导,完成气管插管后分别给予不同目标浓度的七氟醚维持麻醉,观察手术切皮时患者的体动反应,记录术中七氟醚用量和平均消耗速率,采用概率回归法计算七氟醚MAC及其95%可信区间(CI)。结果L组七氟醚MAC为2.08%(95%CI 1.75%~2.30%),七氟醚平均消耗速率为(0.41±0.06)ml/min;H组MAC为1.90%(95%CI 1.78%~2.01%),七氟醚平均消耗速率为(0.36±0.05)ml/min。结论生理周期中不同孕酮浓度可影响七氟醚MAC及用量,黄体期患者七氟醚平均消耗速率慢于卵泡期患者。Objective To explore the effects of different levels of progesterone on minimum alveolar concentration(MAC)and dosage of sevoflurane in female menstrual cycle.Methods Forty-six patients aged 20-40 years,BMI 18-24 kg/m^(2),ASA physical statusⅠorⅡ,undergoing gynecological laparoscopic surgery from June 2019 to December 2020 were divided into two groups:follicular stage group(group L,n=22)and luteal stage group(group H,n=24).Under Narcotrend monitoring,sevoflurane combined with remifentanil were used for anesthesia induction in both groups,and sevoflurane with different target concentrations was given to maintain anesthesia after endotracheal intubation.The body movement reaction of the patients during skin incising was observed.The MAC of sevoflurane,dosage of sevoflurane and the average consumption rate of sevoflurane in the two groups were determined by sequential test.Results The MAC of sevoflurane in group L was 2.08%(95%CI 1.75%-2.30%),and the average consumption rate of sevoflurane was(0.41±0.06)ml/min.The MAC of sevoflurane in group H was 1.90%(95%CI 1.78%-2.01%),and the average consumption rate of sevoflurane was(0.36±0.05)ml/min.Conclusion Different levels of progesterone in the menstrual cycle can affect the MAC and dosage of sevoflurane.The average consumption rate of sevoflurane in luteal stage patients was slower than the follicular stage patients.

关 键 词：孕酮 七氟醚最低肺泡有效浓度 七氟醚用量 

分 类 号：R614[医药卫生—麻醉学]