七氟醚和氨氟醚低流量麻醉在临床麻醉应用中的副作用比较

Comparison of clinical side effect with sevoflurane and enflurane in low flow anesthesia

目的：对七氟醚和氨氟醚在低流量麻醉临床应用时的药物摄取、排除及苏醒和不良反应等情况进行比较。方法：58例ASAⅠ～Ⅱ级腹部肿瘤患者随机分成两组,采用低流量麻醉技术分别吸入七氟醚（S组）和氨氟醚（E组）。麻醉诱导插管后连接Drager麻醉机,七氟醚组挥发罐浓度设置为（Fv）1.2~1.8 MAC（minimum alveolar anesthetic concen-tration,最小肺泡麻醉浓度）（2%~3%）;氨氟醚组挥发罐浓度设置为（Fv）2.2~2.6 MAC（2.5%~3.0%）,均与氧气混合使用。手术过程进行监测。观察患者苏醒时间、有无苏醒期躁动、恶心呕吐及对麻醉的满意度。结果：两组患者麻醉之后到气腹前的MAP（mean airway pressure,平均气道压）、HR（heart rate,心搏率）值偏低,在气腹时两个数值均升高,但是两组之间比较差异无统计学意义（P〉0.05）。术后苏醒期躁动和恶心呕吐发生率S组为25%（7/29）和0%（0/29）,E组分别为35%（10/29）和10%（3/29）,两组比较差异均有统计学意义（χ2=3.43、4.65,均P〈0.05）。结论：七氟醚麻醉诱导快,苏醒期平稳,术后恶心呕吐发生率低,效果更好,副作用较小。

Objective： To compare the differences of absorption,elimination,emergence process,adverse effects between sevoflurane and enflurane in low flow anesthesia.Methods： 58 ASA Ⅰ-Ⅱ patients were randomly divided into two groups,the sevoflurane group（group S） and enflurane group（group E）.Drager anesthesia machine was connected after the anesthetic intubate with vaporizer concentration（Fv） 1.2-1.8 MAC（minimum alveolar anesthetic concentration）（2%-3%） for sevoflurane/O2 and（Fv） 2.2-2.6 MAC（2.5%-3.0%） for enflurane/O2.The surgical process was monitored.Results： The MAP（mean airway pressure） and HR（heart rate） were on the low side from anesthesia to pneumoperitoneum,then elvated a little after pneumoperitoneum.There were no differences between the two groups in this respect（P0.05）.The incidence rates of nausea and restlessness in the postoperative recovery period were lower in the group S（25% and 0） compared to group E（35% and 10%）（P0.05）.Conclusion： The anaesthetic induction with sevoflurane have a faster rate,more stable anesthesia recovery period and lower incidence rate of nausea after surgery,that means a better therapeutic effect and less side effect.