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醫(yī)學(xué)免費(fèi)論文:梗阻性黃疸患者七氟烷麻醉術(shù)后蘇醒時間的臨床觀察
【摘要】 目的 觀察梗阻性黃疸患者七氟烷麻醉術(shù)后的蘇醒時間。方法 60例上腹部手術(shù)患者，ASAⅠ～ Ⅱ級，按血膽紅素分為無黃疸對照組，輕度黃疸組，中度黃疸組，重度黃疸組，每組15例。其中黃疸組患者均為梗阻性黃疸。常規(guī)麻醉誘導(dǎo)后吸入1%～2%七氟烷，維持BIS值45，術(shù)畢即停吸七氟烷。同時記錄從停藥后至BIS值達(dá)到90的時間和喚醒時間。結(jié)果 黃疸組BIS值達(dá)到90的時間和喚醒時間明顯大于非黃疸對照組，但黃疸輕，中，重三組之間無明顯差異。結(jié)論 梗阻性黃疸患者七氟烷麻醉術(shù)后蘇醒時間明顯延長，膽紅素水平與延長的蘇醒時間無明顯相關(guān)性。
【關(guān)鍵詞】 梗阻性黃疸;七氟烷;蘇醒時間
Clinical Observation of Recovery Times From Anesthesia with Sevoflurane in Obstructive Jaundice Patients
Lu Zhijie,Miao Qing,Qiu Haibo,Wang Zhenmeng,Miao Xuerong,Yu Weifeng
(Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438,China醫(yī).學(xué).全.在.線zxtf.net.cn)
Abstract： Objective To observe the recovery times after sevoflurane anesthesia in obstructive jaundice patients. Methods Sixty patients(ASAⅠ-Ⅱlevel) undergoing abdominal surgery were divided into four groups according to the total bilirubin level in blood: control group without jaundice, mild jaundice group, moderate jaundice group and severe jaundice group, with 15 cases of each group. All the jaundice refer to obstructive jaundice. After conventional inducting of anesthesia, 1%-2% sevoflurane was used to maintain the BIS value of 45. At the end of the surgery, sevoflurane, the time reached BIS90 and wakeup time were recorded. Results The recovery times of patients with obstructive jaundice prolonged significantly compared with control group after sevoflurane anesthesia. However, no discrepancies were observed among the groups with different levels of bilirubin. Conclusion Recovery from anesthesia with sevoflurane was delayed in obstructive jaundice patients, but the recovery times was not correlated with the the level of bilirubin醫(yī).學(xué).全.在.線zxtf.net.cn.
Key words： obstructive jaundice; sevoflurane; recovery times
梗阻性黃疸患者血清內(nèi)膽紅素濃度增高，除了肝臟功能本身的損害以外，可能還存在腦內(nèi)神經(jīng)遞質(zhì)的改變，有報道表明阻塞性患者對吸入性麻醉藥的全麻敏感性升高[1]。臨床上七氟烷可能是最理想的新型吸入麻醉藥[2]，其誘導(dǎo)和蘇醒均很迅速，蘇醒期也比較平穩(wěn)。我們對15例非黃疸上腹部手術(shù)患者和45例梗阻性黃疸患者采用七氟烷麻醉，觀察其術(shù)后蘇醒時間，現(xiàn)將結(jié)果報告如下。
