七氟醚紧闭循环麻醉时二氧化碳吸收剂对环路中compound A浓度的影响

Effect of carbon dioxide absorbents on compound A during closed-circuit sevoflurane anesthesia

目的比较七氟醚紧闭循环麻醉时二氧化碳吸收剂对环路中compound A浓度的影响。方法 42例神经外科择期手术患者随机分为Sofnolime组(S组)和Sodasorb LF组(LF组),每组21例。采用七氟醚紧闭循环麻醉,呼气末七氟醚的浓度保持在2.7%～3.5%。监测呼吸环路内compound A的浓度;采集术前、术毕、术后24、72h的血样,检测血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、肌酐(Cr)和尿素氮(BUN)的水平。留取术前、术毕、术后24、48、72h的尿样,检测总蛋白(TP)、β2微球蛋白(β2-MG)和β-N-乙酰氨基葡萄糖苷酶(NAG)。结果 LF组未检测出compound A,S组compound A平均最高浓度为(37.6±10.2)ppm。两组ALT、AST、TBIL、Cr和BUN水平组间、组内比较差异均无统计学意义。两组尿TP/Cr、β2-MG/Cr在术后增加(P<0.05),但各时间点组间比较差异均无统计学意义。两组尿NAG/Cr无变化,组间比较差异无统计学意义。结论七氟醚紧闭循环麻醉时,呼吸环路中compound A的最大浓度低于50ppm,对肝、肾功能无明显影响。

Objective To investigate the influence of different CO2 absorbents on the level of compound A in closed-circuit during sevoflurane anesthesia. Methods Forty-two patients were randomly assigned into two groups of Sofnolime （group S） and Sodasorb LF （group LF） with 21 cases each. The end-tidal concentrations of sevoflurane were maintained at 2. 7%-3.5%. compound A level was determined by gas chromatography at every 30 minutes intervals. The serum ALT, AST, TBIL,BUN, Cr and urine TP,β2-MG were detected at baseline, the end of surgery, 24,48, and 72 hours after surgery. Results The concentrations of compound A were （37.6±10. 2） ppm in group S and d0.1 ppm in group LF. There were no significant differences in serum ALT, AST, TBIL, BUN, Cr and urine NAG/Cr at different time points or between two groups. TP/Cr and β2-MG/Cr in urine were significantly increased after operation, which were not significantly different between two groups. Conclusion The maximal level of compound A is less than 50 ppm in closed-circuit during sevoflurane anesthesia with two CO2 absorbents, which has no any influence on hepatic and renal function.