地氟醚与七氟醚对腹腔镜胆囊切除术患者麻醉复苏情况及手术室周转的影响

Effects of desflurane and sevoflurane on recovery profiles and operating room turnover in patients undergoing laparoscopic cholecystectomy

目的比较两种吸入麻醉药地氟醚与七氟醚对腹腔镜胆囊切除术患者麻醉复苏情况及手术室周转的影响。方法接受腹腔镜胆囊切除术的患者80例,采用随机数字表法分为地氟醚组和七氟醚组,每组40例。地氟醚组吸入6%地氟醚,七氟醚组吸入1.5%七氟醚,均予0.2μg·kg‒1·min‒1瑞芬太尼连续输注复合麻醉。记录两组患者入室时(T_(1))、诱导后(T_(2))、气腹开始时(T_(3))、气腹结束时(T_(4))、拔除喉罩后(T_(5))、出手术室时(T_(6))的心率和MAP,记录患者呼之睁眼时间、自主呼吸恢复时间、定向力恢复时间、改良Aldrete评分达9分时间、出手术室警觉/镇静观察(Observer's Assessment of Alertness/Sedation,OAA/S)评分、拔除喉罩时间和手术结束至出手术室时间,记录两组患者麻醉恢复期间不良反应发生情况。结果两组患者一般情况和各时点心率、MAP比较,差异无统计学意义(P>0.05);与七氟醚组相比,地氟醚组患者呼之睁眼时间、定向力恢复时间、改良Aldrete评分达9分时间、拔除喉罩时间和手术结束至出手术室时间均明显缩短(P<0.05);两组患者自主呼吸恢复时间、出手术室OAA/S评分、麻醉复苏期间不良反应发生率差异无统计学意义(P>0.05)。结论对于腹腔镜胆囊切除术等短小手术,地氟醚与七氟醚相比具有促进患者苏醒、有助于手术室周转的优点。

Objective To compare the recovery profiles and operation room turnover of desflurane vs sevoflurane in patients undergoing laparoscopic cholecystectomy.Methods A total of 80 patients undergoing laparoscopic cholecystectomy were enrolled.According to the random number table method,they were divided into two groups(n=40):a desflurane group and a sevoflurane group.Patients in the desflurane group received 6%desflurane,while those in the sevoflurane group inhaled 1.5%sevoflurane.Furthermore,remifentanil was intravenously infused at 0.2μg·kg‒1·min‒1 for combined anesthesia.Then,both groups were compared for their heart rate and mean arterial pressure(MAP)at admission(T_(1)),after induction(T_(2)),at the beginning of pneumoperitoneum(T_(3)),at the end of pneumoperitoneum(T_(4)),after removal of laryngeal mask airway(T_(5))and when leaving the operating room(T_(6)).The times of eye⁃opening,spontaneous respiratory recovery,orientation recovery,modified Aldrete score up to 9 points,Observer's Assessment of Alertness/Seda⁃tion(OAA/S)scores out of the operation room,the time of removal of laryngeal mask airway and the time from the end of surgery to leav⁃ing the operating room were recorded.Meanwhile,the incidence of adverse effects during anesthesia recovery was recorded in the two groups.Results There were no statistical difference in general information,heart rate and MAP at each time points between the two groups(P>0.05).Compared with the sevoflurane group,the desflurane group showed remarkably decreases in the times of eye⁃opening,orientation recovery,modified Aldrete score of 9 points,removal of laryngeal mask airway and from the end of surgery to leaving the op⁃erating room(P<0.05).There was no statistically significant difference in the time of spontaneous respiratory recovery,OAA/S scores out of the operation room,and the incidence of adverse effects during anesthesia recovery in the two groups(P>0.05).Conclusions Desflurane has the advantages of accelerating patient recovery and promoting operating room turnover,compared with sevoflurane in laparoscopic cholecystectomy.