低流量七氟烷吸入麻醉应用于腹腔镜肾癌切除术患者的效果评估

Clinical observation of the safety and efficacy of sevoflurane low-flow anesthesia performing in laparoscopic surgery of urology

目的观察低流量麻醉在泌尿外科腹腔镜手术患者中的应用,评价低流量麻醉在此类手术中的麻醉效果和应用安全。方法选择60例ASAI-Ⅱ级择期行腹腔镜肾癌切除术的患者,随机分为A、B两组,A组新鲜气体流量为2.5L/min,B组新鲜气体流量为0.5L/min。分别观察两组患者麻醉前、插管后、充气后及拔管前的生命体征,抽取各时段的动脉血进行血气分析,并测定各时段血中的肾上腺素、去甲肾上腺素,同时观察患者的苏醒时间,测量围麻醉期单位时间内消耗的吸入七氟烷的容量。结果 A、B两组患者肾上腺素及去甲肾上腺素水平的变化差异无统计学意义,B组单位时间内七氟烷用量明显低于A组,两组患者围麻醉期的生命体征均平稳。结论七氟烷低流量麻醉可以安全用于泌尿外科腹腔镜患者。

Objective To observe feasibility of low-flow anesthesia in patients undergoing laparo- scopic surgery of urology. Methods 60 patients, scheduled for laparoscopic surgery of urology, were randomly divided into two groups： group＇A and group B. Patients in group A were provided fresh gas flow of 2.5 L/rain, while patients in group B received low-flow （fresh gas flow of 0. 5 L/min） anesthesia. The general body signs were monitored during whole course of anesthesia, and arterial blood was withdraw on pre-operation, after intubation, after inflation and before extubation to detect blood ：gas a3aalysis and concentration of adrenalin and noradrenalin. The dosage of sevoflurane was also meas- ured post-operation. Results There was no difference in plasmatic concentranon of adrenalin and noradrenalin between two groups. Dosage of sevoflurane in group B was significantly less than that in group A. Body signs of patients in two groups were all keep smooth. Conclusions Sevoflurane low-floW anesthesia is safe and effective for patients undergoing lap＇aroscopic surgery of urology.