七氟烷和异氟烷对鼻内镜手术鼻黏膜血流及术野影响的比较

目的 研究七氟烷及异氟烷对血流动力学、鼻腔黏膜微循环血流及术野清晰度的影响.方法 ASA Ⅰ～Ⅱ级择期ESS手术30例,随机分为:七氟烷组(S组,15例)以氧化亚氮-氧-七氟烷维持麻醉;异氟烷组(Ⅰ组,15例)氧化亚氮-氧-异氟烷维持麻醉.两组均将BIS控制在40～50.监测记录术中平均动脉压、心率、诱导前及麻醉平稳后...

The effects of inhaled anesthetics on nasal mucosal blood flow and surgical field in endoscopic sinus surgery

Objective To compare the effects inhaled sevoflurane or isoflurane on nasal mucosal blood flow and visibility of surgical field.Method Thirty Ⅰ～Ⅱ ASA cases undertaking ESS were randomly divided into two groups.Group S (n=15,sevoflurane inhalation),Group I (n=15,isoflurane inhalation).The BIS of the patient was 40～50 during the anesthesia.Invasive blood pressure was measured by dorsalis pedis artery catheterization and HR was recorded.The Laser-Doppler Flowmetry (LDF) was used to measure the mucosal blood flow (PU,CMBC,V) on inferior turbinate and nasal septum before and after anesthesia.Urapidil was applied to control blood pressure when necessary during the operation.The visibility of surgical field was assessed by the same surgeon immediately after the operation.Results In group S,the MAP,HR,PU and V were reduced after anesthesia.In group I,the MAP after anesthesia was decreased but the HR was increased (P<0.05),PU and V in group I were not significantly changed before and after anesthesia (P>0.05).The score of visibility of surgical field in group S was worse than that of the group I (P<0.05).Conclusion Comparing with isoflurane,sevoflurane can reduce the nasal mucosal blood flow and provide good visibility of surgical field,and is more suitable for ESS.