CAJ | 학술논문

目的：评价七氟醚复合瑞芬太尼麻醉持续时间对患者术后苏醒质量的影响。方法ASAⅠ～Ⅱ级择期腹腔镜胆囊手术患者97例，根据吸入麻醉时间不同分为＜90 min组（n＝61）与≥90 min组（n＝36）。观察苏醒期呼气末七氟醚浓度、苏醒时间、血流动力学变化，比较不良反应发生情况及术后24 h患者麻醉满意度。结果两组麻醉时间分别为（70．0±13．2）min和（120．4±27．5）min（P＜0．05）；自主呼吸恢复、呼唤睁眼时及拔管时间差异无统计学意义（P＞0．05）；手术结束时、自主呼吸恢复时、呼唤睁眼时及拔管时四个时间点的血流动力学变化、呼吸末七氟醚浓度比较差异无统计学意义（P＞0．05）；术后患者麻醉满意度评分及不良反应发生率比较差异亦无统计学意义（P＞0．05）。结论七氟醚复合瑞芬太尼麻醉用于不同时长麻醉维持，具有较好的可控性，可有效避免麻醉时间延长导致的药物蓄积、苏醒延迟和血压波动，获得满意的苏醒质量。
목적：평개칠불미복합서분태니마취지속시간대환자술후소성질량적영향。방법ASAⅠ～Ⅱ급택기복강경담낭수술환자97례，근거흡입마취시간불동분위＜90 min조（n＝61）여≥90 min조（n＝36）。관찰소성기호기말칠불미농도、소성시간、혈류동역학변화，비교불량반응발생정황급술후24 h환자마취만의도。결과량조마취시간분별위（70．0±13．2）min화（120．4±27．5）min（P＜0．05）；자주호흡회복、호환정안시급발관시간차이무통계학의의（P＞0．05）；수술결속시、자주호흡회복시、호환정안시급발관시사개시간점적혈류동역학변화、호흡말칠불미농도비교차이무통계학의의（P＞0．05）；술후환자마취만의도평분급불량반응발생솔비교차이역무통계학의의（P＞0．05）。결론칠불미복합서분태니마취용우불동시장마취유지，구유교호적가공성，가유효피면마취시간연장도치적약물축적、소성연지화혈압파동，획득만의적소성질량。
Objective To evaluate the effect of the sevoflurane-remifentanli anesthesia duration on the postoperative recovery quality .Methods 97 patients with ASAⅠ ~ Ⅱ ,who have undergone laparo-scopic cholecystectomy ,were assigned to group <90 min (n=61)and group ≥90 min(n=36) accord-ing to duration of inhalation anesthesia .The changes of end-tidal concentration of sevoflurane during recovery period ,recovery time ,and hemodynamics were recorded .The adverse effects and patients’ satisfaction ratings to anesthesia 24h after surgery were compared between two groups as well .Results The anesthesia durations of both groups were(70 .0 ± 13 .2)min and (120 .4 ± 27 .5)min(P<0 .05)re-spectively .There were no statistical significantly differences in the time from discontinuation of sevoflurane to recovery of spontaneous breathing ,to eyes opening and extubation between two groups (P>0 .05) .Likewise ,there were no statistical significantly differences between two groups in the changes of hemodynamics ,end-tidal concentration of sevoflurane patients’ satisfaction ratings to anes-thesia and the incidence of adverse effects at the four points including end of surgery , recovery of spontaneous breathing ,eyes opening and extubation(P>0 .05) .Conclusion Combined anesthesia with sevoflurane and remifentanil can be used in anesthesia maintenance with different duration to prevent drug accumulation ,delayed recovery and fluctuation in blood pressure due to long anesthesia duration , by which satisfactory recovery quality can be also obtained .