七氟烷逐步减量法对腹腔镜胆囊切除术苏醒时间的影响李华孙波佘.DOCVIP

七氟烷逐步减量法对腹腔镜胆囊切除术苏醒时间的影响 李华 孙波 佘高明 谢红 王琛* 【摘要】 目的 观察七氟烷滴定法在术中BIS监测下对腹腔镜胆囊切除术苏醒时间的影响。 方法 ASA I～II级行择期腹腔镜胆囊切除术患者45例，随机分为3组：Ⅰ（n＝15）组，皮肤缝合结束时停止吸入七氟烷，增加氧流量至10 L/min；Ⅱ（n＝15）组，腹膜缝合结束时停止吸入七氟烷，增加氧流量至10 L/min，静脉推注丙泊酚0.5 mg/kg；Ⅲ（n＝15）组，关闭腹膜即刻，减小七氟烷浓度至0.5 MAC，缝合皮肤结束时停止吸入七氟烷，增加氧流量至10 L/min。观察苏醒时间（自皮肤缝合结束时至患者接受指令睁开眼睛时间）和BIS值达90的时间及生命体征监测指标（MAP、HR、SpO2和PETCO2）。 结果 苏醒时间（min）：Ⅰ组长于Ⅱ、Ⅲ两组（P＜0.05），分别为11.3±6.2、7.2±3.0、4.3±1.9。Ⅲ组苏醒时间短于Ⅱ组（4.3±1.9 vs. 7.2±3.0， P＜0.05）；BIS值达90时的时间（min）：Ⅰ组长于Ⅱ、Ⅲ两组（P＜0.05），分别为14.4±5.4、10.2±4.9和6.8±2.5。Ⅲ组短于Ⅱ组（6.8±2.5 vs. 10.2±4.9，P＜0.05）。 结论 腹腔镜胆囊切除术麻醉苏醒阶段采用七氟烷逐步减量法，可减少联合药物使用的影响，加快病人术后苏醒时间，提高麻醉后苏醒质量。 关键词：七氟烷；胆囊切除术，腹腔镜；苏醒时间 Effect of Sevoflurane titration anesthesia on recovery time in BIS monitoring laparoscopic cholecystectomy. Li hua, Sun bo, She Gao-ming, et al. Department of Anesthesiology, The second affiliated Hospital, Soochow University. Suzhou, 215004, China. Corresponding author: Wang Chen， E-mail: wangchen1791@163.com 【Abstract】 Objective To study the effect of Sevoflurane titration anesthesia in BIS monitoring laparoscopic cholecystectomy on recovery time. Methods forty-five patients (ASA I～II level) undergoing laparoscopic cholecystectomy were randomly divided into three groups: for group I, skin suture end and Stop inhaled sevoflurane, increase oxygen flow to 10 L/min; for group Ⅱ, peritoneal suture end and stop inhaled sevoflurane, increase oxygen flow to 10 L/min, and infusion propofol 0.5 mg/kg; for group Ⅲ, closed peritoneal instantly, reduce inhaled sevoflurane concentration to 0.5 MAC, skin suture end and stop inhaled sevoflurane, increase oxygen flow to 10 L/min (n＝15). Observe the recovery time of stop inhaled sevoflurane to patients open eyes on order and BIS value reached to 90, and MAP, HR, SpO2, PET-CO2 were recorded. Results The recovery time in group Ⅰ was longer than group Ⅱ and group Ⅲ (11.3 ± 6.2, 7.2 ± 3.0, 4.3 ± 1.9, respectively), group Ⅲ was shorter than groupⅡ (4.3 ± 1.9 vs. 7.2 ± 3.0, P＜0.05), and BIS val