七氟醚麻醉腹腔镜手术中应用的临床评价

七氟醚麻醉腹腔镜手术中应用的临床评价
司徒颖芬
【期刊名称】《中国医学创新》
【年(卷),期】2016(13)6
【摘要】目的：观察七氟醚用于腹腔镜手术麻醉诱导和维持时血流动力学变化。

方法：选择72例腹腔镜手术患者，随机均分为两组，分别使用七氟醚和异丙酚麻醉诱导与维持，记录所有患者手术前、吸七氟醚/异丙酚5 min后、插管时、插管
5 min后、气腹时、放气腹时、拔管后的收缩压（SBP）、心率（HR）及平均动
脉压（MAP）、血氧饱和度（SpO2）情况并进行比较；比较拔管时间、清醒时间、止痛时间的差异。

结果：不同麻醉剂诱导后，七氟醚试验组在麻醉5 min及插管
时HR、MAP指标与手术前比较均有微小下降，但差异均无统计学意义
（P>0.05）。

而异丙酚对照组麻醉5 min后HR、MAP显著下降，插管时迅速回升；插管5 min后又逐渐回降，不同手术阶段比较差异均有统计学意义
（P<0.05）。

七氟醚试验组在插管时、插管5 min后、气腹时、放气腹时、拔管
5 min后SBP、HR和MAP均低于异丙酚对照组，差异均有统计学意义
（P<0.05）。

SpO2指标在整个手术过程中均无显著变化，差异无统计学意义（P>0.05）。

两组患者清醒时间、拔管时间、止痛时间比较差异均无统计学意义（P>0.05）。

结论：七氟醚对血流动力学的干扰更小，麻醉维持更稳定，且苏醒快，不良反应少，是值得临床推广应用的一种安全实用的吸入麻醉方法，适用于腹腔镜手术的麻醉。

%Objective: To observe the hemodynamic changes when Sevoflurane anesthesia is used for induction and maintenance in laparoscopic surgery.Method: 72 patients with laparoscopic surgery were
chose, and they were divided into two groups randomly,and done induce and maintenance with Sevoflurane and Propofol&nbsp;anesthesia. The systolic blood pressure (SBP), heart rate (HR) mean arterial pressure (MAP), blood oxygen saturation (SpO2) of two group of patients were recorded and compared at the time of before the operation, Sevoflurane/suction Propofol after 5 min, when intubation, intubation after 5 min, when pneumoperitoneum, when put the pneumoperitoneum and after extubation. And the extubation time, awake time after extubation and analgesic time were compared.Result:After different anesthetic induction, the HR and MAP of the Sevoflurane group when anesthesia for 5 min and intubation had tiny drop, but there were no statistically significant differences (P>0.05). While the Propofol group had a significant reduction, but quick recovery when intubation, and then gradually fell back again after intubation for 5 min, all of the differences had statistical significance (P<0.05). The SBP, HR and MAP of the Sevoflurane group when intubation, intubation for 5 min, when pneumoperitoneum, when put the pneumoperitoneum and extubation after 5 min were lower than the Propofol group. All of the differences were statistically significant (P<0.05). SpO2 indicators had no significant change in the whole operation process (P>0.05). The extubation time, awake time after extubation and analgesic time of the two groups were compared, the differences had no statistical significance(P>0.05).Conclusion: The disturbance on hemodynamic changes use Sevoflurane is smaller, the anesthesia to maintain is more stability, and wake up fast, less adverse reactions. So this method is a kind
of safe inhalation anesthesia method for clinical popularization and application, and suitable for laparoscopic surgery anesthesia.
【总页数】4页(P62-65)
【作者】司徒颖芬
【作者单位】广东省开平市第二人民医院广东开平 529300
【正文语种】中文
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