肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2012年
8期
537-539
,共3页
ZEUS%麻醉,闭合循环%异氟醚%麻醉恢复期
ZEUS%痳醉,閉閤循環%異氟醚%痳醉恢複期
ZEUS%마취,폐합순배%이불미%마취회복기
ZEUS%Anesthesia,closed-circuit%Isoflurane%Anesthesia recovery period
目的 观察患者在异氟醚-ZEUS循环紧闭麻醉苏醒期的临床特征.方法 选择35例美国麻醉师协会( ASA)分级Ⅰ或Ⅱ级在全身麻醉下择期行妇科手术的患者,应用ZEUS麻醉机的Autocontrol 模式,吸入异氟醚-N2O-O2维持麻醉.记录异氟醚的吸入和呼出时间、睁眼时间,麻醉药的用量;记录在停药、自主呼吸恢复、呼之睁眼时的Narcotrend分级(NTS)、Narcotrend指数(NTI)、呼气末异氟醚浓度( EXP)、最低肺泡有效浓度(MAC)、血流动力学指标.术后随访有无术中知晓.结果 与停药时相比,自主呼吸恢复、拔管时的血流动力学指标收缩压( SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)变化显著[(108.1±13.4)mmHg (1mmHg=0.133kPa)、(66.3 ± 12.1 )mm Hg、(84.3±12.5 )mm Hg、( 69.8±12.5)次/min与(124.6±17.9)mm Hg、( 75.7±14.5 )mm Hg、(96.0±14.6 )mm Hg、(82.8±15.0)次/min与(128.0±16.3 )mm Hg、(77.1±15.0)mm Hg、(99.8±15.3) mm Hg、(85.2±18.5)次/min](t=-4.365、-2.951、-3.574、-3.921;t=-5.554、-3.309、-4.642、-4.085,均P＜0.01);NTI、EXP、MAC变化显著[50±7、(0.9±0.0)％、(1.2±0.1)％与74±12、(0.1±0.1)％、(0.2±0.2)％与(86±10)％、0、0](t=-9.382、z=-7.262、z=-7.186;t=-16.682、z=-7.835、z=-7.728,均P＜0.01).术后随访无术中知晓.结论 异氟醚适合ZEUS麻醉机低流量循环紧闭的麻醉方式,但患者意识恢复需要的时间长.
目的 觀察患者在異氟醚-ZEUS循環緊閉痳醉囌醒期的臨床特徵.方法 選擇35例美國痳醉師協會( ASA)分級Ⅰ或Ⅱ級在全身痳醉下擇期行婦科手術的患者,應用ZEUS痳醉機的Autocontrol 模式,吸入異氟醚-N2O-O2維持痳醉.記錄異氟醚的吸入和呼齣時間、睜眼時間,痳醉藥的用量;記錄在停藥、自主呼吸恢複、呼之睜眼時的Narcotrend分級(NTS)、Narcotrend指數(NTI)、呼氣末異氟醚濃度( EXP)、最低肺泡有效濃度(MAC)、血流動力學指標.術後隨訪有無術中知曉.結果 與停藥時相比,自主呼吸恢複、拔管時的血流動力學指標收縮壓( SBP)、舒張壓(DBP)、平均動脈壓(MAP)、心率(HR)變化顯著[(108.1±13.4)mmHg (1mmHg=0.133kPa)、(66.3 ± 12.1 )mm Hg、(84.3±12.5 )mm Hg、( 69.8±12.5)次/min與(124.6±17.9)mm Hg、( 75.7±14.5 )mm Hg、(96.0±14.6 )mm Hg、(82.8±15.0)次/min與(128.0±16.3 )mm Hg、(77.1±15.0)mm Hg、(99.8±15.3) mm Hg、(85.2±18.5)次/min](t=-4.365、-2.951、-3.574、-3.921;t=-5.554、-3.309、-4.642、-4.085,均P＜0.01);NTI、EXP、MAC變化顯著[50±7、(0.9±0.0)％、(1.2±0.1)％與74±12、(0.1±0.1)％、(0.2±0.2)％與(86±10)％、0、0](t=-9.382、z=-7.262、z=-7.186;t=-16.682、z=-7.835、z=-7.728,均P＜0.01).術後隨訪無術中知曉.結論 異氟醚適閤ZEUS痳醉機低流量循環緊閉的痳醉方式,但患者意識恢複需要的時間長.
목적 관찰환자재이불미-ZEUS순배긴폐마취소성기적림상특정.방법 선택35례미국마취사협회( ASA)분급Ⅰ혹Ⅱ급재전신마취하택기행부과수술적환자,응용ZEUS마취궤적Autocontrol 모식,흡입이불미-N2O-O2유지마취.기록이불미적흡입화호출시간、정안시간,마취약적용량;기록재정약、자주호흡회복、호지정안시적Narcotrend분급(NTS)、Narcotrend지수(NTI)、호기말이불미농도( EXP)、최저폐포유효농도(MAC)、혈류동역학지표.술후수방유무술중지효.결과 여정약시상비,자주호흡회복、발관시적혈류동역학지표수축압( SBP)、서장압(DBP)、평균동맥압(MAP)、심솔(HR)변화현저[(108.1±13.4)mmHg (1mmHg=0.133kPa)、(66.3 ± 12.1 )mm Hg、(84.3±12.5 )mm Hg、( 69.8±12.5)차/min여(124.6±17.9)mm Hg、( 75.7±14.5 )mm Hg、(96.0±14.6 )mm Hg、(82.8±15.0)차/min여(128.0±16.3 )mm Hg、(77.1±15.0)mm Hg、(99.8±15.3) mm Hg、(85.2±18.5)차/min](t=-4.365、-2.951、-3.574、-3.921;t=-5.554、-3.309、-4.642、-4.085,균P＜0.01);NTI、EXP、MAC변화현저[50±7、(0.9±0.0)％、(1.2±0.1)％여74±12、(0.1±0.1)％、(0.2±0.2)％여(86±10)％、0、0](t=-9.382、z=-7.262、z=-7.186;t=-16.682、z=-7.835、z=-7.728,균P＜0.01).술후수방무술중지효.결론 이불미괄합ZEUS마취궤저류량순배긴폐적마취방식,단환자의식회복수요적시간장.
Objective To explore the clinical characteristics of patients during recovery period in low flow and circulation closed pattern anesthesia by ZEUS with isoflurane.Methods During elective gynecologic surgery,35 ASA Ⅰ or Ⅱ patients were anesthetized with isoflurane under general anesthesia with tracheal intubation.The ventilation was used with the closed circuit breathing mode (Autocontrol) of ZEUS anesthesia machine.The time of inhale drug,exhale drug and eyes-opend,consumption of drug and complication were recorded during the process.The values of NT stage (NTS),NT index (NTI),the final endexpiratory concentration of isoflurane (EXP),MAC and hemodynamic parameters were recorded during the time of isoflurane stopping inhale,recovery of spontaneous respiration,eyes opening.Results The values of NTI (50±7,74±12,86±10,t =-9.382,t =-16.682,P ＜ 0.01),the EXP [(0.9±0.0)％,(0.1±0.1)％,0,z =-7.262,z =-7.835],MAC [(1.2±0.1)％,(0.2±0.2)％,0,z =-7.186,z =-7.728,P ＜ 0.01] and hemodynamic parameters (SBP,DBP,MAP,HR) [(108.1±13.4) mm Hg (1 mm Hg =0.133 kPa),(66.3±12.1) mm Hg,(84.3± 12.5) mm Hg,(69.8±12.5) /min and (124.6±17.9) mm Hg,(75.7±14.5) mm Hg,(96.0±14.6) mm Hg,(82.8±15.0)/min and (128.0±16.3) mm Hg,(77.1±15.0) mm Hg,(99.8±15.3) mm Hg,(85.2±18.5) bpm] (t =-4.365,t =-2.951,t =-3.574,t =-3.921; t =-5.554,t =-3.309,t =-4.642,t =-4.085,P ＜0.01) during the time of recovery of spontaneous respiration and tracheal extubation were statistically significant compared to the time of isoflurane stopping (P＜ 0.01).None of patients experienced intraoperative was awareness.Conclusion Isoflurane can be used for closed circuit breathing mode of ZEUS anesthesia machine,but consciousness recovery need a long time.
