地氟醚、异氟醚实施循环紧闭麻醉的临床比较

Comparison between Desflurance and lsoflurance in Closed-Circuit Anesthesin

目的 比较地氟醚与异氟醚在循环紧闭麻醉的临床效果及效能价格比。方法 30例择期手术病人 ,分为地氟醚组 (D组 )、异氟醚组 (I组 ) ;麻醉诱导用咪唑安定、芬太尼和琥珀胆碱。气管插管后最初氧流量为 4L/ min,挥发罐浓度 D组、 I组设于 8%和 2 % ,在呼气末浓度分别达 6 %、 1.1%后关闭回路 (氧流量为 0 .2 0～ 0 .35 L / min)行循环紧闭麻醉。D组和 I组 FD调整至 12 %和 4% ,术中维持地氟醚 FA 于 6 %± 0 .1% ,异氟醚 FA 于 1.1%± 0 .1% ;手术结束前 10分钟关闭发挥罐 ,手术后开放回路 ,氧流量 4L/ min,术中予维库溴胺维持肌松。结果 在循环紧闭麻醉中地氟醚的费用比异氟醚便宜约 2 0 %。高流量诱导期 D组和 I组的时间分别为 4.9± 0 .8分和 7.5± 0 .4分 ,微流量后 30分FA/ FI 分别为 90 %和 73%。麻醉结束后地氟醚、异氟醚的 FA 下降至高流量洗出初始时肺泡浓度 FAO的 5 0 %时间分别为1.2± 0 .1分和 1.8± 0 .3分 ,拔管时间、拔管后整体恢复时间 D组明显短于 1组。结论 地氟醚在循环紧闭麻醉中的药代动力学。

Objective:To compare the pharmacokinetics,clinical characteristic and ratio of effective price of desflurane with isoflurane in closed circuit anesthesia.Method:Thirty patients scheduled for surgery were divided into the group of desflurane (group D) and the group of isoflurane (group I).Intravenous induction used midazolam,fentynal and succinycholine.After intubation,O 2 flow was set in 4L/min,vaporizer of group D andgroup I in 8% and 2% respectively.When F A of group D and group I reached at 6% and 1 1% individually,O 2 flow was decreased to 0 20～0 35 1/min,and F D of group D and group I instituted by 12% and 4% separately.During closed anesthesia,F A of group D and group I were maintained in 6%±0 1% and 1 1%±0 1% respectively.10 min before skin closure,vaporizer was closed,After operation,O 2 flow was increased to 4 L/min.Results:The fee of desflurane was 20% cheaper than that of isoflurane.The time of wash in of group D and group I was4 9±0 8 min and 7 5± 0 4 min respectively.After 30 min of closed curcuit,F A/F I of group D and group I was 90% and 73%.After opreation,the half time of F A/F AO of desflurane and isoflurane is 1 2±0 1 min and 1 8±0 3 min individually.The time of extubation,consciousness recovery on groupD was less than groupI.Conclusion:In closed circuit anesthesia,the clinical effect and effect price of desflurane is better than that of isofluranes.