【摘要】 目的　研究老年人吸入麻醉时不同新鲜气流量下地氟醚摄取和清除的特点。方法　选择ASAⅠ～Ⅱ级腹部择期手术 90例 ,分为老年组 4 5例 ,成人组 4 5例 ,根据新鲜气流量的不同 (3、1或 0 5L/min)各分为三组。比较各组 16分钟内地氟醚的FI、FA、FI A值、平衡时间等以及NIBP、HR的改变。然后调节蒸发器使FA 达 4 % ,观察停止吸入后FA 的 5 0 %和 80 %降幅时间以及清醒和拔管时间及即时浓度。结果　老年组 0 5L/min时平衡时间为 11 5分钟 ,显著长于成人组。 3L/min时5 7分钟后有 95 %老年人能达到平衡 ,但老年组有 6 / 15BP降幅超过 30 % ,成人组为 3/ 15。老年人5 0 %降幅时间均较成人组显著延长 ,但 80 %降幅时间无明显差异。老年人平均 6 7分钟后清醒 ,9 1分钟拔管 ,FA 分别为 0 9%和 0 3%。结论　老年人应用地氟醚也有良好的可控性 ,但心血管功能波动较大。调节地氟醚浓度时加大流量可以提高效率。FI A可作为一种相对指标对吸入麻醉药的摄取进行动态观察更多还原

【Abstract】 Objective To evaluate the pharmacokinetics of desflurane with different fresh flow rates in the patients oledr than 65years. Methods 90 cases of ASA physical status Ⅰ Ⅱ were selected.The elderly group( n= 45) and adult group( n= 45) were randomly divided into three groups respectively according to the different fresh flow rates(3,1或0 5L/min).After intubation the concentrations of desflurane(F A,F I)were recorded during the first 16min of intake courses.The 50% and 80% decresed time were recorded during the period of desflurane eliminating from the body.The time F A of awakening and extubation was also recorded.Results During the intaking courses,with the flow rate of 0 5L/min the equation time in the elderly(11 5min) was longer than that in the adult(9 35min).At the rate of 3L/min,the equation time of 95% cases was 5 75min in the elderly.The amount of desflurane intaken was stable at the rates of 0 5L/min and 1L/min in both groups.The time of 50% decrease of the elderly was longer than that of the adult,but the time of 80% decrease had no significantly difference between two groups.Conclusion Desflurane has a better controllability in the elderly patients,but their circulation status should be noticed.The largger flow rate would enhance efficiency.The defference of F A and F I can be used as a relative criterion reflecting the dynamic intake of inhalational anesthetics. [更多还原