靶控吸入七氟烷与传统吸入七氟烷模式麻醉效果比较

目的比较靶控吸入模式与新鲜气体控制吸入模式两种七氟烷吸入模式下手术患者脑电双频指数（BIS）波动、血流动力学稳定性、辅助药物应用、七氟烷消耗量、苏醒情况与术中知晓等方面的差异。方法选择80例拟行脊柱手术的患者,随机分为靶控吸入组（T组）和新鲜气体控制吸入组（F组）,每组40例。两组麻醉诱导相同,顺序静注咪达唑仑0.05 mg/kg和芬太尼4μg/kg后,吸入8%的七氟烷,然后静注维库溴胺0.1 mg/kg,3 min后气管插管。术中麻醉,T组靶控呼出七氟烷浓度为2.3%,F组持续吸入2.3%七氟烷（氧流量1.5 L/min）,两组舒芬太尼按0.15 ng/ml目标血浆浓度靶控输注（TCI）,按需追加维库溴胺。记录并比较两组患者的脑电双频指数（BIS）值、血压、心率、辅助药物剂量、七氟烷消耗量、苏醒时间、苏醒期躁动和术中知晓等情况。结果两组患者均顺利完成手术,T组在术中和结束时的BIS值高于F组（P〈0.05）,T组术中平均动脉压（MAP）高于F组（P〈0.05）,去氧肾上腺素和七氟烷用量明显低于F组（P〈0.05或P〈0.01）,苏醒时间明显短于F组（P〈0.01）,其余指标两组间无显著性差异。结论七氟烷靶控吸入麻醉模式麻醉深度确实可靠,术中血流动力学稳定,七氟烷消耗量低,术后苏醒迅速完全,值得推广应用。

Comparison of anesthesia effect of target-controlled inhalation of sevoflurane with traditional inhalation of sevoflurane

Objective To compare the difference between target-controlled inhalation and fresh-air-controlled inhalation of sevoflurane in bispectral index （BIS） fluctuations, hemodynamic stability, aided drug application, sevoflurane consumption, restlessness time,intraoperative awareness and other indexes. Methods Total 80 patients undergoing spinal operation were divided randomly into target-controlled inhalation group （ group T, n = 40 ） and fresh-air-controlled inhalation group （ group F, n = 40 ）. With the same induction of anesthesia, both groups were administered with intravenous injection of midazolam （0.05 mg/kg） and fentanyl （4 μg/kg） in order, and then inhalation of sevoflurane （8%） and intravenous vecuronium bromide （0.1 mg/kg）, and finally tracheal intubation after three minutes. During intraoperative anesthesia, group T was administered with target-controlled exhalation of sevoflurane with a concentration of 2.3 % , and group F was administered with continuous inhalation of sevoflurane with the same concentration （for which the oxygen flow was 1.5 L/min）. Both groups were administered with target-controlled infusion （TCI） of sufentanil with a plasma concentration of 0.15 ng/ml ,and administered with additional vecuronium bromide as necessary. The BIS value, blood pressure, heart rate,auxiliary drug dose, sevoflurane consumption, resuscitation time, restlessness and intraoperative awareness etc. were recorded. Results Operations were completed successfully to the patients in both groups. The BIS values in group T during and after the operation were higher than those in group F （P 〈 0.05 ）, the intraoperative mean arterial pressure （MAP） in group T was higher than that in group F （ P 〈 0.05 ）, the phenylephrine and sevoflurane dosages in group T were significantly lower than those in group F （ P 〈 0.05 or P 〈 0. 01 ） , and the resuscitation time in group T was significantly shorter than that in group F （ P 〈 0. 01 ） , while other indexes between