张玲美

[摘要] 目的：对七氟醚和氨氟醚在低流量麻醉临床应用时的药物摄取、排除及苏醒和不良反应等情况进行比较。方法：58例ASAⅠ～Ⅱ级腹部肿瘤患者随机分成两组，采用低流量麻醉技术分别吸入七氟醚（S组）和氨氟醚（E组）。麻醉诱导插管后连接Drager麻醉机，七氟醚组挥发罐浓度设置为（Fv）1.2~1.8 MAC（minimum alveolar anesthetic concentration，最小肺泡麻醉浓度）（2%~3%）；氨氟醚组挥发罐浓度设置为（Fv）2.2~2.6 MAC（2.5%~3.0%），均与氧气混合使用。手术过程进行监测。观察患者苏醒时间、有无苏醒期躁动、恶心呕吐及对麻醉的满意度。结果：两组患者麻醉之后到气腹前的MAP（mean airway pressure，平均气道压）、HR（heart rate，心搏率）值偏低，在气腹时两个数值均升高，但是两组之间比较差异无统计学意义（P>0.05）。术后苏醒期躁动和恶心呕吐发生率S组为25%（7/29）和0%（0/29），E组分别为35%（10/29）和10%（3/29），两组比较差异均有统计学意义（χ2=3.43、4.65，均P<0.05）。结论：七氟醚麻醉诱导快，苏醒期平稳，术后恶心呕吐发生率低，效果更好，副作用较小。

[关键词] 七氟醚；氨氟醚；低流量麻醉

[中图分类号] R614[文献标识码] A[文章编号]1673-7210（2011）11（c）-088-02

Comparison of clinical side effect with sevoflurane and enflurane in low flow anesthesia

ZHANG Lingmei

Department of pharmacy, Laiwu Steel Group Hospital, Shandong Province, Laiwu 271126, China

[Abstract] Objective: To compare the differences of absorption, elimination, emergence process, adverse effects between sevoflurane and enflurane in low flow anesthesia. Methods: 58 ASA Ⅰ-Ⅱ patients were randomly divided into two groups, the sevoflurane group (group S) and enflurane group (group E). Drager anesthesia machine was connected after the anesthetic intubate with vaporizer concentration (Fv) 1.2-1.8 MAC (minimum alveolar anesthetic concentration) (2%-3%) for sevoflurane/O2 and (Fv) 2.2-2.6 MAC (2.5%-3.0%) for enflurane/O2. The surgical process was monitored. Results: The MAP (mean airway pressure) and HR (heart rate) were on the low side from anesthesia to pneumoperitoneum, then elvated a little after pneumoperitoneum. There were no differences between the two groups in this respect (P>0.05). The incidence rates of nausea and restlessness in the postoperative recovery period were lower in the group S (25% and 0) compared to group E (35% and 10%) (P<0.05). Conclusion: The anaesthetic induction with sevoflurane have a faster rate, more stable anesthesia recovery period and lower incidence rate of nausea after surgery, that means a better therapeutic effect and less side effect.

[Key words] Sevoflurane; Evflurane; Low flow anesthesia

低流量麻醉可以减少污染、节约费用，并且应用广泛，但是需要较高的流量诱导[1]。七氟醚应用于临床的时间比氨氟醚短，需要更多的临床资料来了解它的使用效果，所以本文将七氟醚和氨氟醚低流量麻醉在腹部肿瘤患者的临床麻醉中的使用情况做了比较。钠石灰与七氟醚作用产生有毒物质[2]，所以本文中使用的是钡石灰[3]。

1资料与方法

1.1一般资料

58例ASAⅠ~Ⅱ级择期行腹部手术的腹部肿瘤患者，随机平均分为七氟醚组（S组）与氨氟醚组（E组），每组29例。S组，男16例，女13例，年龄31~58岁，患者体重54~85 kg；E组，男15例，女14例，年龄32~58岁，患者体重52~84 kg，经检查确认两组全部患者心肺和肝肾功能正常，无高血压病史。在……