摘要
目的通过对七氟醚和异氟醚在EXIT术中的临床观察探讨适合EXIT手术的吸入麻醉剂。方法 5例择期行EXIT手术的孕妇随机分为Ⅰ、S两组,Ⅰ组以异氟醚吸入为主维持麻醉,S组则以七氟醚为主。两组患者术前常规快速静脉诱导后气管内插管,行机械通气。记录两组患者诱导前(T0)、诱导后5min(T1)、母体手术开始时(T2)、取出胎儿时(T3)、断脐时(T4)和手术结束时(T5)母亲的生命体征,包括平均动脉压(MAP)、心率(HR)、经皮脉搏氧饱和度(SpO2)及麻醉深度指数(NTI);胎儿取出时(FT0)、胎儿手术开始时(FT1)、肿瘤切除时(FT2)、胎儿手术结束时(FT3)和断脐时(FT4)胎儿的心率(HR)、经皮脉搏氧饱和度(SpO2)、体温(T)及相应时刻母亲的麻醉深度指数(NTI);记录手术结束停药至苏醒的时间;记录苏醒期不良反应。不良反应包括分泌物增多、恶心呕吐、呼吸抑制、躁动等。结果两组患者各时点的SpO2、HR和Bp值,术后苏醒时间,术中胎儿体温和脉氧均无统计学差异(P>0.05);S组患者的NTI值在T3、T4时较I组有显著降低(P<0.01);S组的胎心率在FT2、FT3时较I组显著增加。结论异氟醚较七氟醚更加适合EXIT的麻醉。
Objective To disguard the more suitable inhalation drug in ex-utero intrapartum treatment（EXIT） anesthesia.Method There were five scheduled EXIT cases randomly divided into group I（n=3） and group S（n=2）： Group I maitained with isoflurane and group S with sevoflurane.All the patients were given endotracheal intubation and mechanical ventilation after rapid intravenous induction.The mothers’ vital signs including MAP,HR,SpO2,MAC and NTI when before induction（T0）,5min after induction（T1）,operate beginning（T2）,fetus removed（T3）,umbilical cord severing（T4） and operate over（T5） were recorded,also the fatues’ HR,SpO2 and temperature when the fetus removed（T0）,fetal operate beginning（FT1）,fetus’ tumor removed（FT2）,fetal operate over（FT3） and umbilical cord severing（FT4）.The time of recovering and side effects should be observed.Result There were no difference between two groups of MAP,HR,SpO2,the time of recovering of mother and the temperature,SpO2 of fetus（P0.05）.There were significant decreasing of NTI at T3 and T4,and were significant increasing of fetus’ HR at FT2 and FT3 in group S compared to group I.Conclusion Isoflurane was more suitable than sevoflurane in EXIT anesthesia.
出处
《中国医药指南》
2012年第33期249-251,共3页
Guide of China Medicine
关键词
子宫外产时治疗
静吸复合全麻
七氟醚
异氟醚
Ex-utero intrapartum treatment
Inhalation anesthesia
Sevoflurane
Isoflurane
