低流量七氟醚用于腹腔镜手术麻醉的价值评价  

Value evaluation of low flow sevoflurane for anesthesiain laparoscopic surgery

作　　者：李庆干 方桥 陈武 LI Qinggan;FANG Qiao;CHEN Wu(Department of Anesthesiology,Honghu People's Hospital,Jingzhou,Hubei,433200,China)

机构地区：[1]洪湖市人民医院麻醉科,湖北荆州433200

出　　处：《当代医学》2024年第22期51-54,共4页Contemporary Medicine

摘　　要：目的探讨低流量七氟醚用于腹腔镜手术麻醉的临床价值、安全性及对循环系统的影响。方法选取2019年7月至2021年12月于洪湖市人民医院行腹腔镜手术治疗的82例患者作为研究对象,采取动态随机法分为参照组与实验组,每组41例。参照组给予单纯静脉麻醉,实验组给予低流量七氟醚吸入复合静脉麻醉。比较两组循环系统功能指标、脑血流量、脑短暂充血反应率、麻醉维持时间、手术时间和术后拔管、自主呼吸恢复、睁眼、清醒时间与认知功能评分及麻醉不良反应发生率。结果麻醉10、30 min,实验组心率(heart rate,HR)快于参照组,收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)均高于参照组,差异有统计学意义(P<0.05)。麻醉10、30 min,实验组脑血流量均少于参照组,差异有统计学意义(P<0.05)。麻醉10、30 min,实验组脑短暂充血反应率均低于参照组,差异有统计学意义(P<0.05)。实验组麻醉维持时间、手术时间均短于参照组,差异有统计学意义(P<0.05)。实验组术后拔管、自主呼吸恢复、睁眼时间、清醒时间均短于参照组,差异有统计学意义(P<0.05)。术后30 min,实验组简易智力状态检查(mini-mental state examination,MMSE)评分高于参照组,意识模糊评估量表(confusion assessment method,CAM)评分低于参照组,差异有统计学意义(P<0.05)。实验组麻醉不良反应发生率低于参照组,差异有统计学意义(P<0.05)。结论腹腔镜手术麻醉中联合低流量七氟醚吸入麻醉,可在维持良好麻醉深度基础上,有效减少静脉麻醉药物用量,减弱对循环系统的影响,稳定脑血流量变化,使患者可在术后短时间内有效苏醒,提升麻醉安全性。Objective To explore the clinical value,safety,and impact on the circulatory system of low flow sevoflurane used for laparoscopic surgery anesthesia.Methods 82 patients who underwent laparoscopic surgery at the People's Hospital of Honghu City from July 2019 to December 2021 were selected as the study subjects,and they were randomly divided into the control group and the experimental group using dynamic randomization method,with 41 cases in each group.The control group was given simple intravenous anesthesia,while the experimental group was given low flow sevoflurane inhalation combined intravenous anesthesia.The circulatory function indicators,cerebral blood flow,transient congestion response rate,anesthesia maintenance time,surgical time,and time of postoperative extubation,spontaneous breathing recovery,eye opening,wakefulness,cognitive function score,and incidence of adverse anesthesia reactions between two groups.Results After 10 and 30 min of anesthesia,the heart rate(HR)in the experimental group was faster than that in the control group group,systolic blood pressure(SBP),and diastolic blood pressure(DBP)in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).After anesthesia for 10 and 30 min,the cerebral blood flow in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).After 10,30 min of anesthesia,the transient congestion response rate in the experimental group were lower than those in the control group,and the difference were statistically significant(P<0.05).The anesthesia maintenance time and surgical time in the experimental group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The postoperative extubation,spontaneous breathing recovery,eye opening time and awake time in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).30 min after

关 键 词：低流量七氟醚 腹腔镜手术 联合麻醉 临床价值 安全性 

分 类 号：R61[医药卫生—外科学]