七氟醚与全凭静脉麻醉对体温影响和术后寒战的发生率比较

Comparison of the effects of anesthesia with sevoflurane and total intravenous anesthesia on the intensity of body temperature reduction during anesthesia and incidence of postoperative chills

目的 比较七氟醚和丙泊酚全凭静脉麻醉患者体温的变化及术后寒战的发生率.方法 60例妇科开腹手术患者,ASA分级Ⅰ～Ⅱ级,按随机数字表法将60例患者分为七氟醚组和全凭静脉组（丙泊酚组）各30例,七氟醚组静脉诱导后全程采用七氟醚（1％～3％浓度）维持术中麻醉;全凭静脉组采用丙泊酚5～10mg/kg＆#183;h持续静脉泵注.在麻醉诱导后每半小时记录体温、心率、平均动脉压.术后在麻醉恢复室记录患者寒战的发生率.结果 两组患者在术中体温、心率、平均动脉压的发生率上无统计学差异（P＞0.05）,术后两组患者寒战的发生率也无统计学差异（P＞0.05）.结论 妇科开腹手术采用七氟醚和丙泊酚全凭静脉维持术中麻醉均是安全、有效的,患者没有发生明显的低温和显著的血流动力学改变以及明显的术后寒战.

Objective To compare the effects of anesthesia with sevoflurane and TIVA （total intravenous anesthesia） on the intensity of body temperature reduction during anesthesia and incidence of chills after gynecological open surgery. Methods 60 ASA physical I or II patients underwent gynecological open surgery were randomly divided into sevoflurane group 30 cases and TIVA group 30 cases. Maintenance of anesthesia were done with Sevoflurane （Concentration of 1-3 %） in Sevoflurane group and in TIVA group with propofol at the dose of 5-10mg/kg/hour. Every half-hour after induction recorded body temperature, heart rate, mean arterial pressure,Chilis rate were recorded in recovery room. Results Changes in body temperature, heart rate, mean arterial pressure and the incidence of postoperative chill rate were not significantly different between the two groups （P〈0.05）. Conclusion It seems that Sevoflurane（Concentration of 1-3% ） and TIVA（propofol at the dose of 5-10mg/kg/h） can be used as safe method of anesthesia in patients with good tolerance gynecological open surgery without hypothermia.