目的:对七氟醚和氨氟醚在低流量麻醉临床应用时的药物摄取、排除及苏醒和不良反应等情况进行比较.方法:58例ASAⅠ～Ⅱ级腹部肿瘤患者随机分成两组,采用低流量麻醉技术分别吸入七氟醚(S组)和氨氟醚(E组).麻醉诱导插管后连接Drager麻醉机,七氟醚组挥发罐浓度设置为(Fv)1.2~1.8 MAC(minimum alveolar anesthetic concentration,最小肺泡麻醉浓度)(2%~3%);氨氟醚组挥发罐浓度设置为(Fv)2.2~2.6 MAC(2.5%~3.0%),均与氧气混合使用.手术过程进行监测.观察患者苏醒时间、有无苏醒期躁动、恶心呕吐及对麻醉的满意度.结果:两组患者麻醉之后到气腹前的MAP(mean airway pressure,平均气道压)、HR(heart rate,心搏率)值偏低,在气腹时两个数值均升高,但是两组之间比较差异无统计学意义(P>0.05).术后苏醒期躁动和恶心呕吐发生率S组为25%(7/29)和0%(0/29),E组分别为35%(10/29)和10%(3/29),两组比较差异均有统计学意义(χ2=3.43、4.65,均P<0.05).结论:七氟醚麻醉诱导快,苏醒期平稳,术后恶心呕吐发生率低,效果更好,副作用较小.%Objective: To compare the differences of absorption, elimination, emergence process, adverse effects between sevoflurane and enflurane in low flow anesthesia. Methods: 58 ASA I - II patients were randomly divided into two groups, the sevoflurane group (group S) and enflurane group (group E). Drager anesthesia machine was connected after the anesthetic intubate with vaporizer concentration (Fv) 1.2-1.8 MAC (minimum alveolar anesthetic concentration) (2%-3%) for sevoflu rane/O2 and (Fv) 2.2-2.6 MAC (2.5%-3.0%) for enflurane/O2. The surgical process was monitored. Results: The MAP (mean airway pressure) and HR (heart rate) were on the low side from anesthesia to pneumoperitoneum, then elvated a little after pneumoperitoneum. There were no differences between the two groups in this respect (P>0.05). The incidence rates of nausea and restlessness in the postoperative recovery period were lower in the group S (25% and 0) compared to group E (35% and 10%) (P<0.05). Conclusion: The anaesthetic induction with sevoflurane have a faster rate, more stable anesthesia recovery period and lower incidence rate of nausea after surgery, that means a better therapeutic effect and less side effect.
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