摘要
目的评价手术时间对肿瘤切除术患者地氟烷药代动力学的影响。方法选取2019年11月至2020年3月行择期全麻手术患者150例,性别不限,年龄18~75岁,BMI 19~25 kg/m2,ASA分级Ⅰ或Ⅱ级,术前肺功能未见异常。麻醉诱导:静脉注射舒芬太尼0.3μg/kg、顺苯磺酸阿曲库铵0.2 mg/kg和丙泊酚2 mg/kg,气管插管术后行机械通气。麻醉维持:吸入地氟烷,调节挥发罐刻度至6%,新鲜气体流量2 L/min,术中根据血流动力学变化及肌肉松弛程度,间断静脉注射舒芬太尼和顺苯磺酸阿曲库铵。记录地氟烷呼气末浓度达0.5 MAC的时间、地氟烷呼气末浓度与挥发罐设定浓度比值达1/2的时间、地氟烷呼气末浓度与吸入浓度比值达1/2的时间、关闭挥发罐即刻地氟烷呼气末浓度降至0.5 MAC的时间和呼气末浓度从0.5 MAC降至0.2 MAC的时间。按照手术时间将患者分为3组:S组手术时间<2 h;M组手术时间2~4 h;L组手术时间>4 h。结果3组间地氟烷呼气末浓度达0.5 MAC的时间、地氟烷呼气末浓度与挥发罐设定浓度比值达1/2的时间、地氟烷呼气末浓度与吸入浓度比值达1/2的时间、关闭挥发罐即刻地氟烷呼气末浓度降至0.5 MAC的时间和呼气末浓度从0.5 MAC降至0.2 MAC的时间比较差异无统计学意义(P>0.05)。结论手术时间不会影响肿瘤切除术患者地氟烷的药代动力学。
Objective To evaluate the effect of operation duration on the pharmacokinetics of desflurane in the patients undergoing tumor resection.Methods One hundred and fifty patients of both sexes,aged 18-75 yr,with body mass index of 19-25 kg/m2,of American Society of Anesthesiologists physical statusⅠorⅡ,in whom abnormal preoperative lung function was not found,undergoing elective surgery with general anesthesia from November 2019 to March 2020,were enrolled in this study.Anesthesia was induced with intravenous injection of sufentanil 0.3μg/kg,cisatracurium besylate 0.2 mg/kg and propofol 2 mg/kg.The patients were tracheally intubated after mechanical ventilation.Anesthesia was maintained with inhalation of desflurane,the vaporizer dial was adjusted to 6%with fresh gas flow rate of 2 L/min,and sufentanil and cisatracurium besylate were intermittently injected intravenously according to the changes in hemodynamics and degree of muscle relaxation during operation.The duration required for the end-tidal concentration of desflurane reaching 0.5 minimum alveolar concentration(MAC),time when the ratio of the end-tidal concentration of desflurane to the pre-set concentration of the vaporizer reached 1/2,time when the ratio of the end-tidal concentration of desflurane to the inhaled concentration reached 1/2,time for the end-tidal concentration of desflurane to decrease to 0.5 MAC and time for the end-tidal concentration to decrease from 0.5 MAC to 0.2 MAC immediately after closing the volatile tank were recorded.The patients were divided into 3 groups according to the operation time:operation time<2 h group(group S),operation time 2-4 h group(group M),and operation time>4 h group(group L).Results There were no significant differences among the 3 groups in the duration required for the end-tidal concentration of desflurane reaching 0.5 MAC,time when the ratio of the end-tidal concentration of desflurane to the pre-set concentration of the vaporizer reached 1/2,time when the ratio of the end-tidal concentration of desflura
作者
白玉
李佳
米琰
卢锡华
周一
缪长虹
Bai Yu;Li Jia;Mi Yan;Lu Xihua;Zhou Yi;Miao Changhong(Department of Anesthesiology,the Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital,Zhengzhou 450008,China;Department of Anesthesiology,Cancer Hospital,Fudan University,Shanghai 200032,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2021年第2期189-191,共3页
Chinese Journal of Anesthesiology
基金
河南省科技攻关项目(LHGJ20190666)
吴阶平医学基金(320.6750.18199)。
关键词
麻醉药
吸入
手术时间
药代动力学
Anesthetics,inhalation
Operative time
Pharmacokinetics
