【摘要】 目的探讨溶解度较低的地氟醚在低流量麻醉中的临床应用价值。方法 ４０例择期手术的胸腹部肿瘤病人，ＡＳＡⅠ～Ⅱ级，分为 Ａ、Ｂ、Ｃ、Ｄ组。 Ａ、Ｂ组氧流量分别为２Ｌ／ｍｉｎ和 ０．５／ｍｉｎ，吸入６％的地氟醚（１ＭＡＣ），观察其肺泡浓度升高速率及差别。Ｃ、Ｄ组分别吸入氧流量为０．５／ｍｉｎ１ＭＡＣ异氟醚和安氟醚作为对照组。结果 Ａ组 ＦＡ／ＦＩ和 ＦＡ／ＦＤ达 １／２的时间分别为 １分钟和 ４分钟；在 １２分钟时 ＦＡ／ＦＩ达到 ０． ８。Ｂ组 ＦＡ／ＦＩ和 ＦＡ／ＦＤ达 １／２的时间分别为 １． ５分钟和 １５分钟，在 ７分钟时 ＦＡ／ＦＩ达到 ０．８１。 ＦＡ／ＦＤ最高达到 ０． ６１。 Ｃ组（异氟醚）的 ＦＡ／ＦＩ达 １／２的时间为 １分钟，ＦＡ／ＦＤ Ｍ达 ０． ３。 Ｄ组（安氟醚）的 ＦＡ／ＦＩ达 １／２的时间为 ４分钟，而 ＦＡ／ＦＤ最高只达 ０． ２。结论地氟醚在低氧流量吸入麻醉时（０．５Ｌ／ｍｉｎ）肺泡浓度和吸入浓度也能较快地达到平衡，在临床使用中更容易调控安全可行，氧流量对地氟醚的肺泡浓度和吸入浓度平衡时间无明显影响，但可影响肺泡浓度的迅速升高。更多还原

【Abstract】 Objective To evaluate the feasibility of inhalation of deaflurane for low-flow anesthesia. Methods Forty adult ASA grade Ⅰ-Ⅱ cancer patients,　scheduled for abdominal and thoracic operation, were randomly divided into four groups (group A,B,C and D). Anesthesia was induced with propofol 1. 5-2.0mg/kg, fentanyl 2-4μg/kg, droperidol 2. sing and atracurrium 0. 6-0. 8mg/kg to facilitate tracheal intubation. After tracheal intubation, anesthesia in group A and B was maintained with 6% desflurane at oxygen flow rate of 2L/min and 0.5%/min respectively. Anesthesia in group C and D was maintained with 1 MAC isoflurane and 1 MAC enflurane at oxygen flow rate of 0. 5L/min as control group respectively. The concentration of desflurane was determined. The FA/FI =1/2 and FA/FD=1/2 were recorded after 30 min of inhalation anesthesia. Results There were no significant differences in age, sex, weight and ASA grade among four groups. During 30-min of inhaling desflurane, the required times at FA/F=1/2 and FA/FD=1/2 were 1.0 min and 4.0 min in group A respectively,the FA/FD was 0. 81 at 12th min, the maximal FA/FD was 0. 86. The required times at FA/FI=1/2 and FA/FD=1/2 were 1.5 min and 15 min respectively in group B,the FA/FI was 0. 8 at 7th min, the maximal FA/FI was 0. 89,but the maximal FA/FD was 0.61. The maximal FA/FD was 0. 3 or 0. 2 in control group, but the increasing rate of the initial isoflurane FA was more rapidly than of enflurane. Conclusion During low-flow anesthesia, desflurane can be rapidly balanced between the concentration of the alveoli and the contration of inspiration. The low-flow desflurane anesthesia is safe, feasible and economical.更多还原