七氟醚复合麻醉和异丙酚用于妇科病腹腔镜手术的血流动力学及苏醒质量的影响对比

Effects of sevoflurane complexed anesthesia on different gynecological with laparoscopic operation hemodynamic and analepsia quality

目的通过对180例妇科腹腔镜手术临床资料的回顾,评价七氟醚麻醉对不同妇科病腹腔镜手术的血流动力学及苏醒质量的影响。方法选择我院妇科腹腔镜手术的患者180例,分为七氟醚及异丙酚两组,每组90例。监测诱导前、插管即刻、插管后5min、切皮时、气腹后、拔管即刻的平均动脉压(MAP)、心率(HR)、呼末二氧化碳分压(PETCO2);记录手术时间、诱导时间、停药至喉罩拔除时间、意识恢复时间(呼之睁眼)、麻醉恢复室停留时间、术中疼痛及术后恶心、呕吐发生率。结果七氟醚组插管后5min、切皮时的MAP高于异丙酚组组,差异具有统计学意义(P<0.05);七氟醚组各时间段PETCO2低于异丙酚组组,差异具有统计学意义(P<0.05);两组患者腹腔镜手术麻醉及恢复时间无显著影响,拔除气管导管时的不良反应,术后恶心、呕吐发生率比较差异无统计学意义(P>0.05)。结论经七氟醚诱导的复合麻醉吸入过程平稳,苏醒迅速,可以满足不同种类妇科腹腔镜手术的麻醉要求。

Objective To evaluate the effects of sevoflurane anesthesia on different gynecological with laparoscopic operation hemodynamic and analepsia quality by reviewing the clinical data of 180 cases and to discuss the relevant influence factors of analepsia. Methods In the period of January 2012 to December 2012,information of 180 gynecological laparoscopy cases were compared and analyzed. The patients were divided into Sevoflurane group and Propofol group,90 cases in each group. MAP,HR and PetCO2 were observed respectively before induction,intubation,intubation 5min,skin incision and pneumoperitoneum after extubation. Operation time,induction time,stopping to LMA removal time,consciousness recovery time （call open eyes）,PACU stay time,intraoperative and postoperative pain,nausea and vomiting incidence and other adverse events were recorded. Results Sevoflurane group after intubation 5min,incision MAP is higher than the propofol group,the difference was statistically significant （P〈0.05）;sevoflurane group at each time PETCO2 below than propofol group,the difference was statistically significant （P〈0.05）;There are no statistical differences in recovery time,adverse reaction,postoperative nausea and vomiting incidence among the two groups （P 〉0.05）. Conclusion The intravenous anesthesia with sevoflurane inhalation anesthetics procedure is a safety anesthesia method with fast analepsia and can be applied in different patients undergoing laparoscopic gynecologic surgery.