CAJ | 학술논문

目的：探讨妇科腹腔镜手术中人工气腹对七氟醚吸入麻醉肺摄取的影响。方法拟择期在全身麻醉下行全子宫切除术的患者40例，根据手术方式的不同分为两组（ n＝20）：腹腔镜组（ A组）和开腹组（ B组），分别于吸入麻醉后5min（T1），15min（T2），30min（T3）及停止吸入麻醉前（T4），监测记录七氟醚吸入浓度（Fi）和呼出浓度（Et）、脑电双频指数（BIS）、气道峰压（Ppeak）、血压（BP）、心率（HR）、呼气末CO2分压（PET CO2）、动脉血CO2分压（ Pa CO2），根据Et，Fi计算Et／Fi比值。结果两组间的血压、心率、BIS比较无明显差异（P＞0．05），A组的气道峰压高于B组（P＜0．05），A组的PETCO2、PaCO2高于B组（P＜0．05），两组间的Fi比较无明显差异（P＞0．05），A组Et低于B组（P＜0．05），A组Et／Fi低于B组（P＜0．05）。结论在妇科腹腔镜手术中人工气腹使七氟醚的摄取量增加，两组患者BIS反映的麻醉深度无明显差异。
목적：탐토부과복강경수술중인공기복대칠불미흡입마취폐섭취적영향。방법의택기재전신마취하행전자궁절제술적환자40례，근거수술방식적불동분위량조（ n＝20）：복강경조（ A조）화개복조（ B조），분별우흡입마취후5min（T1），15min（T2），30min（T3）급정지흡입마취전（T4），감측기록칠불미흡입농도（Fi）화호출농도（Et）、뇌전쌍빈지수（BIS）、기도봉압（Ppeak）、혈압（BP）、심솔（HR）、호기말CO2분압（PET CO2）、동맥혈CO2분압（ Pa CO2），근거Et，Fi계산Et／Fi비치。결과량조간적혈압、심솔、BIS비교무명현차이（P＞0．05），A조적기도봉압고우B조（P＜0．05），A조적PETCO2、PaCO2고우B조（P＜0．05），량조간적Fi비교무명현차이（P＞0．05），A조Et저우B조（P＜0．05），A조Et／Fi저우B조（P＜0．05）。결론재부과복강경수술중인공기복사칠불미적섭취량증가，량조환자BIS반영적마취심도무명현차이。
[ ABSTRACT] Objective To study the effect of artificial pneumoperitoneum in laparoscopic surgery on lung uptake of sevoflurane anesthesia.Methods Forty patients to be operated with hysterectomy under general anesthesia were selected, they were divided into two groups depending on surgical approach,laparoscopic group A(n=20) and laparotomy group B(n=20).When sevoflurane was started,in-haled concentration(Fi) and exhaled concentrations(Et),bispectral index(BIS),peak airway pressure(Ppeak),blood pressure(BP),heart rate(HR),end-tidal CO2 partial pressure(PETCO2) and arterial partial pressure of CO2(PaCO2) were monitored and recorded at five minutes ( T1 ) ,fifteen minutes( T2 ) ,thirty minutes( T3 ) ,and before the end of surgery to stop inhaling sevoflurane( T4 ) and the Et /Fi was calculat-ed.Results The blood pressure,heart rate and BIS of the two groups had no statistical difference(P>0.05),the peak airway pressure of Pneumoperitoneum group was higher than that of the laparotomy group(P<0.05),end-tidal CO2 partial pressure and arterial partial pressure of CO2 of Pneumoperitoneum group were higher than those of the laparotomy group(P<0.05),there was no significant difference between Fi of the two groups(P>0.05),the Et and E/Fi of pneumoperitoneum group were lower than those in the laparotomy group(P<0.05).Con-clusion Artificial pneumoperitoneum in laparoscopic surgery can make patients intake much more sevoflurane,there is no significant differ-ence between the depth of anesthesia of the two groups reflected by BIS.