七氟醚及异丙酚用于全麻诱导效果比较.docVIP

七氟醚及异丙酚用于全麻诱导效果比较 　【摘要】; 目的 七氟醚和异丙酚用于全麻诱导，比较两者麻醉效果及对患者血流动力学、应激反应的影响。方法 选择40例LC手术患者，ASAⅠ级或Ⅱ级，年龄18～65岁，随机分为两组(n=20)，七氟醚组(S组)，吸入1 MAC七氟醚麻醉诱导，异丙酚TCI组(P组)，靶控输注血浆靶浓度3 mg/L，异丙酚麻醉诱导。患者入室静卧5 min后记录血压(BP)、心率(HR)作为基础值。记录插管前即刻(T1)、插管后2 min(T2)、5 min(T3)、10 min(T4)的BP、HR、血糖和患者意识消失的时间。结果 与基础值比较，T1、T2时两组BP、血糖均下降(P＜0.05)，S组HR减慢(P＜0.01)；T2时P组BP下降(P＜0.01)；T4时P组BP下降(P＜0.05)；组间比较，T4时P组HR较S组快(P＜0.05)，S组BP较P组升高明显(P＜0.05)，P组血糖较S组高(P＜0.05)。S组意识消失时间短于P组(P＜0.01)。结论 七氟醚吸入麻醉比异丙酚静脉麻醉应激反应小，血流动力学变化小，更适合于全麻诱导。 【关键词】; 异丙酚；七氟醚；全麻诱导 ; ［Abstract］; Objective; To compare the effects of induction with sevoflurane and propofol in stress reaction and hemodynamics.Methods; Forty ASAⅠorⅡ patients aged 18～65 were randomized into 2 groups(n=20):sevoflurane group (S) and propofol group （P).In group S induced with anesthesia was started with 5% sevoflurane and fresh gas flow rate of 5 L/min.The inspired concentration of sevoflurane was reduced to 1 MAC.In group P induced with TCI of propofol.The target plasma concentration (CT)of propofol was at 3 mg/L.Then observed the variation of blood BP，HR，blood sugar in different time in both groups.The time of loss of consciousness (LOC)was recorded.Results; BP，blood sugar in both groups and HR in group S were significantly decreased immediately before intubation as compared with the baseline values before induction of anesthesia (P＜0.01).BP and HR returned to the baseline levels after intubation.HR was significantly lower after intubation in group S than in group P.Blood sugar level in group P was much higher than group S after intubation 10 min (P＜0.01).The time of LOC was significantly shorter in group S than in group P (P＜0.01).Conclusion; Induction of anesthesia with sevoflurane can lead to less stress and minor variation in hemodynamics than injection of propofol，so it is better for anesthesia. ; ［Key words］; propofol；sevoflurane；general anesthesia inducing ; 七氟醚是一种新型吸入全身麻醉剂，该药具有良好的麻醉性能，它血气分配系数低，对呼吸道刺激作用小，诱导期短，苏醒快，麻醉过程平稳，可以安全用于成人、儿童和老年人的麻醉。异丙酚近年来已广泛应用于临床麻醉及ICU镇静