低流量七氟醚靶控吸入与丙泊酚TCI的临床对比研究

A Clinical Comparison Between Low Flow Sevoflurane Target-Controlled and TCI of Propofol

目的：观察七氟醚靶控用于低流量吸入麻醉维持的临床规律及血流动力学变化，寻求靶控下的药物量化指标。方法：选择60例20～60岁手术患者，随机分2组每组30例：P组（丙泊酚）常规实施全凭静脉TCI靶控麻醉；S组（七氟醚），实施低流量七氟醚靶控吸入麻醉（BIS值40）。分别记录诱导前（T1），插管后5（T2）、15（T3）、30（T4）45（T5）、60（T6）、90（T7）、120（T8）min时的、MBP、HR、；Sev组患者加记各个时点的七氟醚IT、ET的MAc值。结果：T2点两组均比T1降低（P〈0．05），S组高于P组（P〈0．05），两组比较T3至T7无显著性差异（P〉0．05）；S组T3至T7各点ET值无统计学差异，ET％：2．46，约1．4MAc。结论：（1）七氟醚诱导较静脉麻醉诱导患者血流动力学稳定，（2）低流量七氟醚靶控吸入麻醉维持平稳，调控简便，效果良好。

Objective： To ohserve the clinic regulation and the change of homodynamic in Sevoflurane low flow target-controlled Inhalational anesthesia, and explore the quantitative indicators of medicine under the target control. Methods： Sixty adult Patients scheduled to undergo surgery were divided into two groups randomly：Sevoflurane group （S group） and propofol group（P group）. All the patients of P group were injected pronofol intravenously; low flow Sevoflurane target controlled Inhalational anesthesia used to S group（BIS is 40）. Recorded the changes of MAP, HR in preinduced（T1）and After the tracheal intuhation 5（T2）,15（T3）,30（T4）45（TS）,60（T6）,90（T7）,120（T8）min respectively; excepting that the S group rescore the MAC of zhe Sevofluranes＇ IT,ET at the same time. Results： Statistical difference was observed between T2 and TI（P〈0. 05） ,P group and S group respectively（P〈0.05）;there is no statistical difference compare T3 with T7（P〉0.05） ; ET is 2.46, MAC is 1.4. Conclusion： The change of homodynamic induced by Sevoflurane is light than intravenously, the maintenances of low flow Sevoflurane target-controlled Inhalational anesthesia is stable,convenient and efficient.