临床腹腔镜手术中给予七氟醚低流量吸入麻醉的安全性及有效性研究  

Study on the safety and efficacy of low flow sevoflurane anesthesia during laparoscopic surgery

作　　者：唐伟 杨蓉蓉 TANG Wei;YANG Rong-rong(Department of Anesthesiology,960th Hospital,Joint Logistic Support Force,Chinese People's Liberation Army,Jinan 250000,China)

机构地区：[1]中国人民解放军联勤保障部队第九六〇医院麻醉科,250000 [2]泰安市妇幼保健院,271000

出　　处：《中国现代药物应用》2024年第15期86-89,共4页Chinese Journal of Modern Drug Application

摘　　要：目的分析七氟醚低流量吸入麻醉在腹腔镜手术中的应用价值。方法146例腹腔镜手术患者,依据随机抽样法分为观察组和对照组,每组73例。对照组采用丙泊酚静脉麻醉,观察组则采用七氟醚低流量吸入麻醉。比较两组患者不同时间的平均动脉压、心率以及麻醉相关指标(拔管时间、麻醉复苏时间、自主呼吸恢复时间)、不良反应发生情况。结果两组在麻醉前(T1)时的平均动脉压、心率比较,差异无统计学意义(P>0.05);观察组气腹后5 min(T2)、气腹后30 min(T3)、手术结束即刻(T4)时的平均动脉压分别为(73.6±8.6)、(82.3±10.3)、(85.6±10.6)mm Hg(1 mm Hg=0.133 kPa),均低于对照组的(79.6±12.3)、(88.6±12.6)、(92.4±13.1)mm Hg,心率分别为(73.6±8.6)、(80.3±9.2)、(83.3±10.5)次/min,均低于对照组的(82.5±9.4)、(88.4±10.5)、(92.5±11.5)次/min,差异有统计学意义(P<0.05)。观察组患者拔管时间(9.4±1.5)min、麻醉复苏时间(7.2±0.6)min、自主呼吸恢复时间(6.5±0.5)min均短于对照组的(12.6±2.3)、(10.5±1.2)、(9.2±0.9)min,差异有统计学意义(P<0.05)。观察组麻醉不良反应发生率4.1%低于对照组的13.7%,差异有统计学意义(P<0.05)。结论腹腔镜手术应用七氟醚低流量吸入麻醉具有较高的安全性与有效性,可以维持术中血流动力学指标的稳定性,缩短麻醉复苏时间,不良反应少,值得推广使用。Objective To analyze the practical value of low-flow sevoflurane anesthesia during laparoscopic surgery.Methods 146 laparoscopic surgery patients were randomly sampled into an observation group and a control group,with 73 cases in each group.The control group was given propofol intravenous anesthesia,and the observation group was given low-flow sevoflurane inhalation anesthesia.Patients in both groups were compared in terms of mean arterial pressure,heart rate,anesthesia related indexes(extubation time,anesthesia resuscitation time,spontaneous respiration recovery time)at different times,and the occurrence of adverse reactions.Results There was no significant difference in mean arterial pressure and heart rate between the two groups before anesthesia(T1)(P>0.05).In the observation group,the mean arterial pressure at 5 min after pneumoperitoneum(T2),30 min after pneumoperitoneum(T3)and immediately after operation(T4)were(73.6±8.6),(82.3±10.3)and(85.6±10.6)mm Hg(1 mm Hg=0.133 kPa),which were lower than(79.6±12.3),(88.6±12.6)and(92.4±13.1)mm Hg in the control group;the heart rate were(73.6±8.6),(80.3±9.2)and(83.3±10.5)beats/min,which were lower than(82.5±9.4),(88.4±10.5)and(92.5±11.5)beats/min in the control group;the difference was statistically significant(P<0.05).In the observation group,the extubation time was(9.4±1.5)min,the anesthesia resuscitation time was(7.2±0.6)min,the spontaneous respiration recovery time was(6.5±0.5)min,which were shorter than(12.6±2.3),(10.5±1.2),(9.2±0.9)min in the control group.The difference was statistically significant(P<0.05).The incidence of adverse anesthetic reactions in the observation group was 4.1%,which were lower than 13.7%in the control group,and the difference was statistically significant(P<0.05).Conclusion Low-flow sevoflurane anesthesia in laparoscopic surgery has high safety and effectiveness,and can maintain the stability of intraoperative hemodynamic indexes,shorten anesthesia recovery time with less adverse reactions.It is worthy of promotion.

关 键 词：腹腔镜手术 七氟醚 低流量吸入麻醉 血流动力学 

分 类 号：R614[医药卫生—麻醉学]