老年经腹腔镜胆囊摘除术中七氟烷对循环功能的影响

Effects of Sevoflurane on Circulatory Function in Elderly Patients during Laparoscopic Cholecystectomy

目的:探讨全凭七氟烷麻醉在老年腹腔镜手术中对循环功能的影响。方法:选择58例择期进行腹腔镜手术的老年患者,采用全凭七氟烷麻醉的方法,分别记录入室后麻醉给药前、诱导后1.5min、插管时、插管后2min、插管后5min、气腹放气后的HR、SBP、DBP、MAP,并记录停药至苏醒的时间及苏醒时相应血浆靶浓度。结果:插管时HR、SBP、和MAP与麻醉给药前比较均升高(P<0.05),气腹放气后SBP、DBP和MAP也较麻醉给药前明显升高(P<0.05),其它各观察时点血流动力学参数与给药前比较无统计学差异。停药至患者初醒的平均时间为(10.24±5.35)min,相应血浆靶浓度为(1.41±0.55ug/ml)。结论:采用七氟烷麻醉对改善老年腹腔镜手术患者的预后具有重要意义。

Objective：To discuss the influence of total sevoflurane anesthesia on circulatory function in elderly patients during laparoscopic surgery.Methods：Fifty-eight elderly patients with laparoscopic surgery were anesthetized by adopting sevoflurane.After the patients entered the operating room,the results of HR,SBP,DBP and MAP were recorded respectively at the following time points：before induction,1.5 minutes after induction,intubation,2 min and 5min after intubation,and immediately after deflation of pneumoperitoneum.The awakening time after drug withdrawal and the corresponding plasma target concentration were recorded,as well.Results：The levels of HR,SBP and MAP recorded at the intubation time point are higher than those recorded before induction（P〈0.05）;compared with the levels of SBP,DBP and MAP measured immediately before induction,the levels after deflation of pneumoperitoneum increased significantly（P〈 0.05）.There was no statistical difference of hemodynamic parameters between each observation point and the point before induction.The average awakening time after drug withdrawal was（10.24±5.35）min,and the corresponding plasma target concentration was（1.41±0.55ug/ ml）.Conclusion：Adopting sevoflurane anesthesia may play a significant role in ameliorating prognosis of elderly patients after laparoscopic surgery.