七氟醚与异氟醚麻醉在腹腔镜胆囊切除术中的效果比较

目的探讨七氟醚与异氟醚麻醉在腹腔镜胆囊切除术（LC）中的效果比较。方法选择80例LC手术患者，分为七氟醚组与异氟醚组，两组患者均在麻醉诱导后行气管插管、机械通气。七氟醚组麻醉维持采用吸入七氟醚，异氟醚组麻醉维持采用吸入异氟醚。结果两组患者麻醉前MAP、HR比较无明显统计学差异（P〉0．05），气腹后5min、苏醒时异氟醚组患者MAP、HR与麻醉前比较明显上升且高于相应时间点的七氟醚组（P〈0．05）。七氟醚组术后睁眼时间、拔出气管插管时间和Aldrete评分达到9分时间均少于异氟醚组。且七氟醚组术后苏醒期躁动发生率明显少于异氟醚组（χ^2=5．00，P〈0．05）。两组患者的术后4hMMSE评分与麻醉前比较均明显下降（P〈0．05），且异氟醚组下降的幅度与七氟醚组比较更显著（P〈0．05），术后12h两组患者MMSE评分均恢复至麻醉前水平。结论LC手术采用吸入七氟醚麻醉较吸入异氟醚麻醉具有麻醉恢复时间短、麻醉恢复质量好、术后苏醒期躁动发生少、减轻LC手术应激反应的特点，对术后认知功能的影响较小。尤其适合老年手术患者的麻醉。

The comparison of the effects of sevoflurane and isoflurane using in laparoscopic cholecystectomy

Objective To compare the effects of sevoflurane and isoflurane using in laparoscopic cholecystectomy. Methods All 80 patients who would get LC were divided into two groups as sevoflurane group and isoflurane group. All patients were anesthetized and followed by tracheal intubation with artificial ventilation. Sevoflurane group used sevoflurane during the maintenance of anesthesia, and the isoflurane group used isoflurane. Results MAP and HR of the two groups showed no differences before anesthesia. At the time points of 5 min later after pneumoperitoneum, and when patient came, the MAP and HR of isoflurane group raised significantly comparing with before anesthesia and that of sevoflurane group （P 〈 0.05）. The times from stopping administration of anesthetics until eye openingand tracheal extubationand the MMSE score of sevoflurane group were significantly less than that of isoflurane group （χ^2=5.00, P 〈 0.05）, and so was the emergence agitation rate after surgery （χ^2=5.00, P 〈 0.05）, the MMSE scores 4 h after surgery of both groups decreased significantly than those before surgery （P 〈 0.05）, and the down-range of isoflurane group was more obvious than that of sevoflurane group （P 〈 0.05）. The MMSE score 12 h after surgery of the two groups recovered back to the level before anesthesia. Conclusion Sevoflurane inhalation anesthesia makes a better performance than isoflurane in LC surgery because of short-recovery time, perfect-recovery quality, low-emergence-agitation rate and stress-reaction reducing of LC, and shows little influence on cognitive function after surgery, so it is more suitable for old patients.