异氟烷及七氟烷用于腹部手术闭环靶控吸入麻醉对照探究.docVIP

异氟烷及七氟烷用于腹部手术闭环靶控吸入麻醉对照探究 　 作者：王翠萍　范立霞　类维富 【摘要】 　　目的:比较在腹部手术闭环靶控吸入麻醉中，七氟烷与异氟烷在脑电双频指数(BIS)波动、血液动力学稳定性、辅助药物应用、苏醒情况与术中知晓等方面的差异。方法：40例择期腹部手术的患者分为七氟烷组（25例）与异氟烷组（15例）。两组均采用经静脉诱导、吸入麻醉药闭环靶控系统维持麻醉；采用BIS为反馈控制变量，并设定BIS值55为控制目标。记录并比较两组的BIS值、血压、心率、辅助药物剂量、苏醒时间、苏醒期躁动和术中知晓等数据。结果：两种药物对麻醉全程的BIS、HR、和脉压差比较差异无统计学意义，但在术中七氟烷组BIS波动与收缩压波动显著小于异氟烷组（Plt;0.05）。七氟烷组睁眼时间显著少于异氟烷组（Plt;0.01）；两组躁动发生差异无统计学意义。但两组亚宁定与麻黄碱用量比较无统计学显著性差异。两组病人均无术中知晓发生。结论：在腹部手术闭环靶控吸入麻醉中，七氟烷与异氟烷相比，可减少术中的BIS和收缩压的波动，缩短患者的睁眼时间。 【关键词】 脑电描记术　双频指数　闭环控制　麻醉　吸入　 异氟烷　 七氟烷 　　Comparative study of isoflurane and sevoflurane on the effects of anesthesias in abdominal surgeries with the close-loop anesthesia system 【ABSTRACT】 Objectives: To study the differences between sevoflurane and isoflurane in abdomen surgery anesthetized with the target-controlled close-loop anesthesia system．Methods: Forty patients (ASA I-II) were divided into sevoflurane group (n=25) and isoflurane group (n= 15)．BIS value of 55 was the control variable index．The target-controlled infusion system of sevoflurane was administered for the maintenance of anesthesia in both groups after intravenous nduction. The BIS values，blood pressures，heart rates and doses of assistant drugs were recorded and analyzed．Results: No statistical difference was observed in BIS、HR and pulse pressure in two groups. During the maintenance of anesthesia, oscillations of BIS and SBP in sevoflurane group were statistically less than those in isoflurane group (Plt;0.05). The time to open the eyes was statistically less in sevoflurane group (Plt;0.01). Times of restlessness showed no difference in two groups. The doses of ephedrine and Ebrantil used were not statistically different. No patients reported awareness or recall of intraoperative events. Conclusion: In abdominal surgeries, anesthesia with the closed-loop anesthesia system using sevoflurane may statistically reduce restlessness and oscillations of BIS and SBP in the maintenance of anesthesia compared with isoflurane. 　　近年来,吸入靶控麻醉成为麻醉