七氟醚与异氟醚吸入麻醉对腹腔镜胆囊切除术患者麻醉后苏醒及认知功能的影响

目的探讨七氟醚与异氟醚吸入麻醉对腹腔镜胆囊切除术患者麻醉后苏醒及认知功能的影响。方法 100例腹腔镜胆囊切除术患者随机分为观察组与对照组,分别采用七氟醚和异氟醚吸入麻醉。结果观察组自主呼吸恢复时间、睁眼时间、拔管时间和定向力恢复时间均短于对照组（P〈0.05或P〈0.01）,苏醒期躁动发生率低于对照组（χ^25.01,P〈0.05）。两组患者麻醉后MMSE评分均较麻醉前下降（P〈0.05或P〈0.01）。两组T1时MMSE评分均较麻醉前明显降低（P〈0.05或P〈0.01）,且对照组降低幅度较观察组更明显（P〈0.05）;对照组T2时MMSE评分较T0时及观察组T2时均明显降低（P〈0.05）,两组T3时MMSE评分与麻醉前比较差异均无统计学意义（P〉0.05）。两组治疗期间无明显药物不良反应。结论腹腔镜胆囊切除术患者采用七氟醚吸入麻醉具有苏醒更快,睁眼、拔管时间更短,苏醒期躁动发生率低,安全性较好等优点。

Influence of sevoflurane and isoflurane inhalation anesthesia on postanesthetic analepsia and cognitive function of patients with laparoscopic cholecystectomy

Objective To discuss influence of sevoflurane and isoflurane inhalation anesthesia on postanesthetic analepsia and cognitive function of patients with laparoseopic cholecystectomy （LC）. Methods 100 cases of patients planned to be treated by LC operation were selected and divided into observation group and control group randomly. The patients in observation group were given sevoflurane inhalation anesthesia, while the patients in control group were given isoflu- rane inhalation anesthesia. Results The spontaneous breathing recovery time, EO time, extubation time, and orientation recovery time of patients in observation group were all much shorter than those in control group （P〈0.05 or P〈0.01）, and the incidence rate of agitation in up period of patients in observation group was much lower than that in control group （χ^2=5.01, P〈0.05）. The MMSE scores of patients in two groups after anesthesia obviously declined than that in preanes- thesia （P〈0.05 or P〈0.01）. The MMSE scores of patients in two groups at TI obviously declined than that in preanesthesia （P〈0.05 or P〈0.01）, and the declining rate of patients in control group was much higher than that in observation group （P〈0.05）. MMSE score of patients in control group at T2 was much lower than that at Tc, as well as that in observation group at T2 （P〈0.05）. After comparing the MMSE scores at T3 and T0, no obvious differences appeared （/9〉0.05）. There were no obvious adverse drug reaction（ADR） during treatment in two groups. Conclusion The application of sevoflurane inhalation anesthesia on patients with LC has the virtue of shorter analepsia time, EO time, extubation time, low inci- dence rate of agitation in up period, weaker influence on cognitive function and best safety.