CAJ | 학술논문

目的比较单纯七氟醚吸入麻醉与异丙酚-舒芬太尼静脉麻醉用于妇科日间手术患者的效果.方法拟行门诊人上流产术患者140例,年龄18～35岁,体重45～ 65kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将患者随机分为2组(n=70):异丙酚-舒芬太尼静脉麻醉组(Ⅰ组)和单纯七氟醚吸入麻醉组(Ⅱ组).Ⅰ组静脉注射舒芬太尼0.2μg/kg,静脉输注1％异丙酚2～3mg· kg -1·min-1,睫毛反射消失后,以3～4 mg·kg-1·h-1的速率静脉输注.Ⅱ组面罩吸入8％七氟醚,氧流量6 L/min,待睫毛反射消失后,将氧流量调至3 L/min,七氟醚挥发罐划度调至2％～3％.记录麻醉诱导时间、苏醒时间、手术时间、术中低氧血症发生情况、体动情况及相关不良事件发生情况.结果与Ⅰ组比较,Ⅱ组麻醉诱导时间延长,苏醒期躁动、恶心、呕吐发生率升高,性幻觉发生率降低(P＜0.05),手术时间、苏醒时间、寒战、低氧血症发生率和体动反应分级比较差异无统计学意义(P＞0.05).结论与单纯七氟醚吸入麻醉相比,异丙酚-舒芬太尼静脉麻醉更适用于妇科日间手术患者,有利于改善患者麻醉恢复质量.
목적 비교단순칠불미흡입마취여이병분-서분태니정맥마취용우부과일간수술환자적효과.방법 의행문 진인상유산술환자140례,년령18～35세,체중45～ 65kg,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법,장환자수궤분위2조(n=70):이병분-서분태니정맥마취조(Ⅰ조)화단순칠불미흡입마취조(Ⅱ조).Ⅰ조정맥주사서분태니0.2μg/kg,정맥수주1％이병분2～3mg· kg -1·min-1,첩모반사소실후,이3～4 mg·kg-1·h-1적속솔정맥수주.Ⅱ조면조흡입8％칠불미,양류량6 L/min,대첩모반사소실후,장양류량조지3 L/min,칠불미휘발관화도조지2％～3％.기록마취유도시간、소성시간、수술시간、술중저양혈증발생정황、체동정황급상관불량사건발생정황.결과 여Ⅰ조비교,Ⅱ조마취유도시간연장,소성기조동、악심、구토발생솔승고,성환각발생솔강저(P＜0.05),수술시간、소성시간、한전、저양혈증발생솔화체동반응분급비교차이무통계학의의(P＞0.05).결론 여단순칠불미흡입마취상비,이병분-서분태니정맥마취경괄용우부과일간수술환자,유리우개선환자마취회복질량.
Objective To compare inhalational anesthesia with sevoflurane and intravenous anesthesia with propofol-sufentanil in patients undergoing gynecological outpatient surgery.Methods One hundred and forty ASA Ⅰ or Ⅱ patients,aged 18-35 yr,weighing45-65 kg,undergoing outpatient painless abortion,were randomly divided into 2 groups ( n =70 each):intravenous anesthesia with propofol-sufentanil group (group Ⅰ ) and inhalational anesthesia with sevoflurane group (group Ⅱ ).In group Ⅰ,sufentanil 0.2 μg/kg was injected intravenously,and 1％ propofol was infused at 2-3 mg·kg-1 ·min-1,followed by a rate of 3-4 mg·kg-1 ·h-1 after loss of eyelash reflex.In group Ⅱ,8％ sevoflurane was inhaled and the oxygen flow rate was 6 L/min,and after loss of eyelash reflex,the oxygen flow rate was adjusted to 3 L/min,and the concentration of sevoflurane was adjusted to 2％-3％.The time of induction of anesthesia,emergence time,operation time,intraoperative hypoxemia,body movement and related adverse events were recorded.Results Compared with group Ⅰ,the time of induction of anesthesia was significantly prolonged,the incidence of agitation,nausea and vomiting was significantly increased,and the incidence of sexual hallucinations was significantly decreased ( P ＜ 0.05),while no significant change was found in the operation time,emergence time,and incidence of shivering,intraoperative hypoxemia and body movement in group Ⅱ ( P ＞ 0.05 ).Conclusion Intravenous anesthesia with propofol-sufentanil is more helpful in improving the quality of emergence from anesthesia and more suitable for gynecological outpatient surgery than inhalational anesthesia with sevoflurane.