地氟醚低流量麻醉在单肺通气中的临床应用

目的:观察应用低流量麻醉技术吸入地氟醚在单肺通气时对循环及呼吸系统的影响。方法:45例肺部肿瘤患者,采用低流量麻醉技术吸入地氟醚麻醉,每分钟新鲜气流0.7～1L/mine,术中间断给予芬太尼2滋g/(kg·h),阿曲库胺0.4mg/kg及持续吸入地氟醚维持麻醉,地氟醚吸入维持在1~1.5MAC之间。术中均行单肺机械通气。在麻醉的不同时期采取动脉血进行血气分析,同时监测SBp、MAP、DSP、HR、SpO2、PetCO2。以自身麻醉诱导气管插管平稳后与吸入地氟醚后比较,以麻醉诱导后为对照组。结果:地氟醚以8%～10%的浓度吸入8~10min与自身麻醉诱导气管插管平稳后比较,SBp有显著性差异(P<0.05)、MAP、DSP均有所下降,但无显著差异(P>0.05)。SpO2无明显变化。低流量吸入地氟醚单肺通气15min时较单肺通气血气前分析示PaO2下降,PaCO2升高,通过增加吸入氧浓度和呼吸频率后血气分析指标恢复正常。结论:应用低流量地氟醚麻醉在开胸手术单肺通气时安全可行。

Clinical use of low-volume anesthesia with inhalation of desflurane in one-lung ventilation

Objective To observe the influences of low-volume anesthesia technology with inhalation of desflurane on circulation and respiratory systems during one-lung ventilation. Method Forty-five patients with pulmonary tumor were undertaken pneumonoresection in low-volume anesthesia technology with inhalation of desflurane, and all ventilated with one-lung during the Surgery. Blood-gas analysis was done at the different time. Results compared with preanesthesia,there is a significant difference in SBp after 8~10minutes inhalation of desflurane(P<0.05),while MAP and DSP decrease lightly(P>0.05). After 15minutes with one-lung ventilation, blood-gas analysis show us that PaO2 decreases while PaCO2 elevates,and by increasing FiO2 and respiratory frequency they revert to normal. Conclusion low-volume anesthesia technology with inhalation of desfluurane is safe and effective in one-lung ventilation during thoracic Surgeries.