紧闭循环麻醉时七氟醚对病人肝肾功能的影响

目的 评价紧闭循环麻醉时七氟醚对病人肝肾功能的影响.方法 拟行普外科手术病人40例,ASA Ⅰ或Ⅱ级,年龄20～60岁,随机分为2组(n=20),麻醉诱导后S1.组和S2组分别吸人6%～8%国产或进口七氟醚,新鲜气流量2～4 L/min,2～3 min后调整新鲜气流量至0.18～0.30 L/min,随后维持七氟醚呼气末浓度2.6%～3.5%.于术前、术毕、术后1、2、3和5 d时测定血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)活性、总胆红素(TB)、肌酐(Cr)、尿素(BUN)、β2-微球蛋白(β2-MG)浓度和尿液β2-MG浓度.结果 与术前比较,术毕、术后1、2 d时两组尿液β2-MG浓度升高(P<0.05),术后1～5血清ALT、AST活性和TB、Cr、BUN和β2-MG浓度差异无统计学意义(P0.05);各指标组间比较差异无统计学意义(P0.05).结论 紧闭循环麻醉时七氟醚对病人肝肾功能无明显影响.

Effects of closed-circuit sevoflurane anesthesia on hepato-renal function

Objective To assess the hepato-renal function after closed-circuit anesthesia with sevoflurane. Methods Forty ASA Ⅰ orⅡ patients aged 20-60 yr undergoing operation lasting more than 120 min under general anesthesia were randomized to receive either domestically-produced sevoflurane (group D, n=20) or imported sevoflurane (group Ⅰ, n=20). Fresh gas flow was first set at 2-4 L/min for 2-3 min then reduced to 0.18-0.30 L/min. The end-tidal sevoflurane concentration was maintained at 2.6%-3.5%. ECG, BP, HR, SpO2, PETCO2, ispiratory and expiratory O2 and sevoflurane concentrations were continuously monitored during operation. Blood samples were taken from peripheral vein before anesthesia (T0 ,baseline), at the end of surgery (T1) and 1, 2, 3, 5 d after operation (T2.5) for determination of serum alanine transaminase (ALT), aspartate transaminase (AST) activity, total bilirubin (TB), creatinine (Cr), blood urea nitrogen (BUN) and β2 microglobulin (β2-MG) concentrations. Urine specimens were taken for determination of β2-MG concentration at the same time periods. Resuits There were no significant differences in serum ALT, AST activity, TB, Cr, BUN and β2-MG concentrations before and after operation as well as between the 2 groups. Β2-MG concentration in urine was significantly increased at T1-3 as compared with the baseline value at To in both groups but was not significandy different between the 2 groups. Conclusion Closed-circuit anesthesia with sevoflurane has no significant adverse effect on hepato-renal function.