七氟醚低流量满刻度洗入、低流量洗出紧闭麻醉法用于小儿手术的可行性研究

目的分析七氟醚低流量满刻度洗入,低流量洗出紧闭麻醉法在小儿手术中的应用价值。方法将42例择期手术患儿随机均分为A,B两组。挥发罐内七氟醚均达最大刻度。麻醉时A组患儿采用0.3L/min氧流量洗入。B组患儿采用1.0L/min氧流量洗入。当肺泡内七氟醚浓度至1.3MAC,将挥发罐刻度设定在3%~8%。手术结束前10min关闭挥发罐,调整氧流量为0.3L/min洗出。手术结束时将氧流量增至5L/min快速洗出。结果两组患儿在洗入期消耗量并无差别(P>0.05)。而A组患儿在维持期及总用量上明显低于B组患儿(P<0.01)。两组患儿在麻醉时间上差异无统计学意义。而A组患儿苏醒时间及意识恢复时间均明显短于B组患儿(P<0.01)。结论七氟醚低流量满刻度洗入,低流量洗出紧闭麻醉法可达到小儿手术对麻醉要求,且具有降低七氟醚消耗量及麻醉废气生成量,缩短苏醒及意识恢复时间等优点。

Feasibility Study of Sevoflurane Wash-in Low-flow with Full Scale,Wash-out of Low-flow Anesthesia with Closed-circuit in the Using of Pediatric Surgery

Objective To analyse the clinical effect of sevoflurane wash-in low-flow with full scale, wash-out of low-flow anesthesia with closed-circuit in the using of pediatric surgery. Methods Randomly divided 42 children who were scheduled for surgery into A and B group. Sevoflurane in the volatile tank was on the largest scale before anesthesia. Patients in the A group were assigned to wash-in in 0.3L/min of oxygen when patients in B group were wash- in 1.0L/min. When the density of sevoflurane in pulmonary alveoli reached 1.3MAC,adjusted scale of volatile tank keeping 3%-8%.Closed volatile tank before i0 mins of surgery, and adjusted the oxygenflow to 0.3L/min.Added the oxygenflow to 5L/min quickly wash-out when the surgery was finished. Results Consumption of sevoflurane in the wash-in period was not different between the two group. But the consumption in the maintain-period and the total consumption in A group were obviously lower than those in B group（P〈0.01）.There was no difference between the two groups＇ anesthesia. But the recovery time and the consciousness recovery time in A group were obviously shorter than the data in B group（P〈0.01）. Conclusion Sevoflurane wash-in low-flow with full scale, wash-out of low-flow anesthesia with closed-circuit sizes up the requirement of Pediatric surgery, and it has the advantage of reducing the consumption of sevoflurane and the producing of waste anesthetic gas,shorten the recovery time and the consciousness recovery time.