七氟醚麻醉深度对单肺通气时肺顺应性的影响(1)
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【摘要】 目的 观测不同最低肺泡有效浓度(MAC)七氟醚对单肺通气(OLV)时肺顺应性的影响。方法 选择45例择期左开胸手术患者，ASA Ⅰ~Ⅱ级，随机分为七氟醚0.5 MAC组(Ⅰ组)1.0 MAC(Ⅱ组)和1.5 MAC(Ⅲ组)三组,每组15例。三组均用芬太尼2 μg/kg,依托米脂0.2 mg/kg和琥珀胆碱(司可林)1.5 mg/kg进行麻醉诱导，然后经口插入右双腔支气管导管控制呼吸，术中七氟醚分别以0.5 MAC、1.0 MAC和1.5 MAC，瑞芬太尼以0.5 μg/(kg•h)，维库溴铵以0.05 mg/(kg•h)维持麻醉。在MAC值稳定后分别记录侧身双肺通气0、3 min单肺通气2、3、 4、 5、15 min的气道压、气道压峰值(Ppeak)、气道平台压(Pplat)、血氧饱和度(SaO2)、平均动脉压(MAP)、呼气末二氧化碳(PETCO2)和顺应性。结果 OLV后3组患者的顺应性明显降低(P<0.05),其他参数均无差异；OLV后Ⅲ组与其他两组之间差异有统计学意义(P<0.05)。结论 1.5 MAC七氟醚在右侧单肺通气时对顺应性有明显增强效应，0.5 MAC和1.0 MAC 七氟醚影响轻微。
【关键词】
七氟醚；单肺通气；肺顺应性
Subject effect of different concentrations of Sevoflurane on lung complince during onelung ventilation
WANG Weiqiang. Sujiatun Central Hospital，Shenyang 110101,China
【Abstract】 Objective
To observe the alterations of lung compliance during different concentrations of sevoflurane anesthesia in patients undergoing thracic surgery.Methods Fortyfive ASAⅠ~Ⅱ patients scheduled for elective leftside thoracic surgery were divided into three groups randomly and equally. Anesthesia was induced with Fentanyl 2 μg/kg、Etomidate0.2 mg/kg and succinglcholine 1.5 mg/kg.And doublelumen endotracheal tubes were intubated.Anesthesia was maintained with sevoflurane (MAC=0.5，1.0，1.5 respectively) inhalation and Remifentanil pumped in a dose of 2 μg/(kg•h).and Vecuronium Bromide pumped in a dose of 0.05 μg/(kg•h).After MAC stabilizing,plateau airway pressure、Ppeak 、Pplat、SaO2、 MAP、 HR、 PETCO2 and lung compliance were measured0，3 min after twolung ventilation 2，3，4，5 and 15 min after the right onelung ventilation respectivelly.Results Lung compliancedecreased significantly during OLV than TLV(P<0.05),there were no significant differences with respect to other indexes.No significant differece was found in lungcompliance among the three groups during TLV (P>0.05).The third group had significant difference than the other two groups undergoing OLV (P<0.05).Conclusion During the right OLV,Sevoflurane 1.5 MAC enhance significantly lung compulance,while sevoflurane 0 ......
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