俯卧位腰椎手术患者全凭静脉麻醉和七氟烷平衡麻醉后肺功能的比较

【目的】比较俯卧位腰椎手术患者全凭静脉麻醉和七氟烷平衡麻醉对术后肺功能的影响。【方法】选择择期行俯卧住腰椎手术的患者96例。美国麻醉医师学会分级I～Ⅱ级。随机均分为全凭静脉组（T纽）和七氟烷组（S组）各48例。T组术中静脉泵注芬太尼和丙泊酚维持麻醉，S组吸入七氟烷和50％N2O维持麻醉。术前和术后分别测量两组患者的用力肺活量（FVC），第1秒用力呼气量（FEVl），最大呼气中断流量（MEF25～75），最大呼气流量（PEF）。记录两组患者的手术时间、麻醉时间。【结果】术前两组患者一般资料和肺功能参数比较差异无显著性（P〉0．05），术后所有呼吸参数较术前均有下降（P〈0．01），而且TIVA组患者的FVC下降比BAL组更明显（P〈0．05）。结论]TIVA和用七氟烷BAL用于俯卧位腰椎手术患者，术后短期内均可出现肺功能减退。TIVA患者全麻苏醒后的FVC相对术前下降比用七氟烷BAL更明显。

Comparison of Postoperative Lung Function of Patients Undergoing Lumbar Surgery at Prone Position after Total Intravenous Anaesthesia vs Balanced Anesthesia with Sevoflurane

Objective]To compare the postoperative lung function between total intravenous anesthesia （TIVA） and balanced anesthesia（BAL） with sevoflurane in patients undergoing lumbar surgery at prone position. Methods] A total of 96 patients（American Society of Anesthesiologists I-Ⅱ ） undergoing elective lure bar surgery were randomly assigned to TIVA group（group T） and BAL with sevoflurane group（group S）. Group T was intravenously injected with fentanyl and propofol for maintenance anesthesia. Group S inhaled sevoflurane and 50%N20 for maintenance anesthesia. Forced vital capacity（FVC）, forced expiratory volume in ls（FEV1）, mid-expiratory flow（MEF 25-75） and peak expiratory flow（PEF） were measured before and after anesthesia. Anesthesia and operation durations were also recorded. Results]There was no significant difference in the general data and lung function parameters between two group before operation（ P 〉0.05）. Compared with before operation, lung function parameters decreased after operation（ P d0.01） and the FVC of TIVA group decreased more significantly than BAL group（ P〈0.05）. Conclusion] Both T1VA and BAL with sevoflurane in patients undergoing lumbar surgery at prone position may occur the reduction of lung function in the short term after operation. Compared with before operation, the FVC of TIVA patients after gener at anesthesia recovery decrease more obviously than BAL with sevoflurane.