地氟醚、异氟醚实施循环紧闭麻醉的临床比较

目的　比较地氟醚与异氟醚在循环紧闭麻醉的临床效果及效能价格比。方法　 30例择期手术病人 ,分为地氟醚组 (D组 )、异氟醚组 (I组 ) ;麻醉诱导用咪唑安定、芬太尼和琥珀胆碱。气管插管后最初氧流量为 4L/ min,挥发罐浓度 D组、 I组设于 8%和 2 % ,在呼气末浓度分别达 6 %、 1.1%后关闭回路 (氧流量为 0 .2 0～ 0 .35 L / min)行循环紧闭麻醉。D组和 I组 FD调整至 12 %和 4% ,术中维持地氟醚 FA 于 6 %± 0 .1% ,异氟醚 FA 于 1.1%± 0 .1% ;手术结束前 10分钟关闭发挥罐 ,手术后开放回路 ,氧流量 4L/ min,术中予维库溴胺维持肌松。结果　在循环紧闭麻醉中地氟醚的费用比异氟醚便宜约 2 0 %。高流量诱导期 D组和 I组的时间分别为 4.9± 0 .8分和 7.5± 0 .4分 ,微流量后 30分FA/ FI 分别为 90 %和 73%。麻醉结束后地氟醚、异氟醚的 FA 下降至高流量洗出初始时肺泡浓度 FAO的 5 0 %时间分别为1.2± 0 .1分和 1.8± 0 .3分 ,拔管时间、拔管后整体恢复时间 D组明显短于 1组。结论　地氟醚在循环紧闭麻醉中的药代动力学、临床效果及效能价格比明显优于异氟醚

Comparison between Desflurance and lsoflurance in Closed-Circuit Anesthesin

Objective: To compare the pharmacokinetics, clinical characteristic and ratio of effective-price of desflurane with isoflurane in closed-circuit anesthesia. Method: Thirty patients scheduled for surgery were divided into the group of desflurane (group D) and the group of isoflurane (group I). Intravenous induction used midazolam, fentynal and succinycholine. After intubation, O2 flow was set in 4L/min, vaporizer of group D and group I in 8% and 2% respectively. When FA of group D and group I reached at 6% and 1.1% individually, O2 flow was decreased to 0. 20～0. 35 1/min, and FD of group D and group I instituted by 12 % and 4 % separately. During closed anesthesia, FA of group D and group I were maintained in 6 % + 0. 1% and 1.1% ± 0. 1% respectively. 10 min before skin closure, vaporizer was closed, After operation, O2 flow was increased to 4 L/min.Results: The fee of desflurane was 20% cheaper than that of isoflurane. The time of wash-in of group D and group I was 4. 9±0. 8 min and 7. 5±0.4 min respectively. After 30 min of closed-curcuit, FA/FI of group D and group I was 90% and 73%. After opreation, the half time of FA/FAO of desflurane and isoflurane is 1.2 ± 0. 1 min and 1.8 ± 0. 3 min individually. The time of extubation, consciousness recovery on groupD was less than groupI. Conclusion: In closed-circuit anesthesia, the clinical effect and effect-price of desflurane is better than that of isoflurane's.