摘要
目的:探讨腹腔镜胆囊切除术中七氟烷用药浓度对麻醉效果的影响。方法:收集2018年1月—12月择期行腹腔镜胆囊切除术治疗患者60例,按术中七氟烷吸入浓度分为常规浓度组30例,术中维持1~2最低肺泡有效浓度(MAC)七氟烷吸入,至皮肤缝合结束时停用;低浓度组30例,患者先给予1~2 MAC七氟烷吸入,至关闭腹膜时下调七氟烷浓度至0.5 MAC,皮肤缝合结束时停用。比较两组术中瑞芬太尼总用量、麻醉总时间、手术总时间、麻醉苏醒时间、脑电双频指数(BIS)值恢复至90所需时间以及拔管前即刻各项生命体征指标情况。结果:两组患者术中瑞芬太尼总用量、麻醉总时间、手术总时间对比差异均无统计学意义(P>0.05)。低浓度组麻醉苏醒时间为(4.55±1.26)min,BIS值恢复至90所需时间为(6.84±2.07)min,均低于常规浓度组的(11.42±3.37)min和(14.50±3.63)min(P<0.05)。两组拔管前即刻血压、心率、呼气末CO2分压、动脉血氧饱和度水平对比差异均无统计学意义(P>0.05)。结论:腹腔镜胆囊切除术中减少七氟烷用药浓度能在不改变麻醉效果和生命体征指标基础上缩短苏醒时间,提高苏醒质量,值得临床推荐。
Objective:To investigate the influence of sevoflurane concentration on anesthetic effect in laparoscopic cholecystectomy.Methods:A total of 60 patients who underwent laparoscopic cholecystectomy from January 2018 to December 2018 were collected,and according to the inhalation concentration of sevoflurane during operation,they were divided into a conventional concentration group with 30 cases,and during the operation,1-2 minimum alveolar effective concentration(MAC)of sevoflurane was maintained,and stopped at the end of skin suture;the low concentration group had 30 patients,inhalation of 1-2 MAC sevoflurane was given at first,then the concentration of sevoflurane was lowered to 0.5 MAC when the peritoneum was closed,and the use of sevoflurane was discontinued at the end of skin suture.The total dose of remifentanil,the total time of anesthesia,the total time of operation,the time of anesthesia recovery,the time required for the bispectral index(BIS)to return to 90,and the vital signs immediately before extubation were compared between the two groups.Results:There were no significant differences in the total dosage of remifentanil,total anesthesia time and total operation time between the two groups(P<0.05).The recovery time of anesthesia in the low concentration group was(4.55±1.26)min,and the time required for the BIS value to return to 90 was(6.84±2.07)min,which were lower than those in the conventional concentration group(11.42±3.37)min and(14.50±3.63)min(P<0.05).There were no significant differences in blood pressure,heart rate,end-tidal CO2 partial pressure,and arterial oxygen saturation level between the two groups immediately before extubation(P>0.05).Conclusion:Reducing the concentration of sevoflurane in laparoscopic cholecystectomy can shorten the recovery time and improve the quality of recovery without changing the anesthetic effect and vital signs,which is worthy of clinical recommendation.
作者
徐慧
周文娟
XU Hui;ZHOU Wenjuan(Department of Anesthesiology of Jian Hospital,Shanghai Oriental Hospital,Jian 343000,Jiangxi Province,China)
出处
《上海医药》
CAS
2020年第2期26-28,共3页
Shanghai Medical & Pharmaceutical Journal
关键词
胆囊疾病
腹腔镜切除术
七氟烷
gallbladder disease
laparoscopic resection
sevoflurane
