腹腔镜手术中七氟醚和异氟醚麻醉对应激反应的影响研究

Stress responses of sevoflurane and isoflurane inhaled anesthesia in laparoscope cholecystectomy

目的:比较七氟醚和异氟醚麻醉在腹腔镜胆囊切除术(laparoscope cholecystectomy,LC)中对应激反应的影响,为手术提供一种合理的麻醉方式。方法:40例按照美国麻醉师协会(American Society of Anethesiologists,ASA)健康状况与麻醉风险分级标准Ⅰ～Ⅱ级择期行LC术患者,随机分成七氟醚组(Ⅰ组)和异氟醚组(Ⅱ组)。于诱导前和术后清醒时检测两组患者皮质醇(CORTISOL)及血糖(GLU)水平。结果:Ⅰ组拔管时的皮质醇和血糖浓度较诱导前无明显增加(P>0.05),且较Ⅱ组低。结论:七氟醚较异氟醚更能有效的抑制LC术中应激反应,且血流动力学更平稳,更适合于麻醉的选择。

Objective：To observe the effects of stress responses of sevoflurane and isoflurane inhaled anesthesia in laparoscope cholecystectomy,and to provide a more ideal anesthesia method. Methods：Forty ASAⅠ-Ⅱ patients arranged for laparoscope cholecystectomy were randomly divided into two groups, sevoflurane group（ Ⅰgroup,n=20） and isoflurane group（Ⅱgroup,n=20）. Testing two groups were in Cortisone and blood glucose before anesthesia induction and after surgery.Results：Cortisone and blood glucose increased compared with before anesthesia induction in Ⅰ group, and were higher than that in Ⅱ group. Conclusions： Sevoflurane is better than isoflurane in depressing stress responses in LC and decreasing the fluctuation of hemodynamics,so it is better for anesthesia.