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題 名 | Comparison of Hemodynamics and Recovery of Sevoflurane and Isoflurane Anesthesia in Chinese Adult Patients=使用Sevoflurane及Isoflurane於中國人成年病患麻醉時血流動力學及恢愎之比較研究 |
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作 者 | 陳大樑; 楊素芬; 張懷嘉; 戴裕庭; 黎乃良; 林珍榮; | 書刊名 | 麻醉學雜誌 |
卷 期 | 36:1 1998.03[民87.03] |
頁 次 | 頁31-36 |
分類號 | 416.5 |
關鍵詞 | 吸入性麻醉劑:sevoflurane isoflurane; 血流動力學:血壓心跳; 麻醉甦醒:遵從醫令噁心嘔吐; Anesthetics inhalational:sevoflurane isoflurane; Hemodynamics:blood pressure heart rate; Emergence:verbal command nausea vomiting; |
語 文 | 英文(English) |
中文摘要 | 背景:sevoflurane 為一新型之強力吸入性麻醉劑,由於其身血相 / 氣相溶解 參數較低,故可預期甦醒較快。本研究當試在 ASA I~II 類病人接受 sevoflurane 及 isoflurane 麻醉時,比較其血流動力學及甦醒時間之差異性。 方法:ASA I~II 類八十位病人,預定接受例行性婦科及一般外科手術,隨機分為兩組 ,一組接受 sevoflurane 麻醉(四十位病人),另一組接受 isoflurane 麻醉(四十位病 人),氣管插管後,立即給予氣流量 2 升 / 分鐘下 1-1.5MAC 濃度之任何一種麻醉氣體, 並同時監測心跳、動脈血壓、食道溫度、脈動血氣飽和濃度以及潮氣未二氧化碳含量。任何 副作用如誘導或甦醒之時,氣道之刺激,或術後之噁心 - 嘔吐皆予以記錄,並詳細評估病 人清醒以及可以聽從醫囑之時間,術後亦追蹤其噁心嘔吐之發生率及接受麻醉之滿意度。 結果:麻醉氣體濃度與使用時間之乘積,在兩組病人並無明顯差異。血流動力學方面, 收縮壓與舒張壓於維持麻醉之變化,兩者無統計上之差異。而心跳方面,isoflurane 組則 於劃刀後,明顯高於 sevoflurane 組( p<0.05 )。於麻醉甦醒期間,對遵從醫囑所需之 反應時間,sevoflurane 組明顯短於 isoflurane 組( 5.6 ± 0.4 分鐘 vs.15.2 ± 3.0 分鐘, p<0.001 )。其他副作用如術後噁心嘔吐之發生率,兩組無明顯差異。 結論:臨床上 isoflurane 組相比,以 sevoflurane 麻醉可提供中國人成年病患較穩 定之血流動力學及較快速之甦醒。 |
英文摘要 | Background: The new inhalational anesthetic sevoflurane would be expected to provide a rapid emergence from anesthesia due its low blood/gas partition coefficient. In this study, we compared the hemodynamic effects, speed and quality of emergence, in ASA class I-II, Chinese abult surgical patients receiving either sevoflurane or isoflurane anesthesia. Methods: Eighty adult Chinese patients, ASA class I-II scheduled for elective gynecological or general surgical procedures, were randomized to receive sevoflurane(n=40) or isoflurane (n=40) anesthesia. Ventilation is controlled via endotracheal intubation with anesthesia facilitated by either agent at anesthetic concentration of 1-1.5 MAC under the fresh gas flow 2 L/min. heart rate, arterial blood pressure, temperature, SpO □ and end-tidal CO □ were continuously monitored. Any adverse effect such as airway irritation, nausea or vomiting was recorded during iduction and emergence form anesthesia. The emergence time was assessed by various questionales for orientation during recovery. In the post-anesthetic recovery period, pain was monitored and managed by objective pain discomfort scale for analgesic supplements. Complaints of nausea and vomiting were recorded and followed up by a research nurse who visited the patient within 24 following surgery. Results: The extent of exposure to anesthetic (MAC × hours) was similar in both groups. Sevoflurane and isoflurane caused similar alterations in systolic and diastolic arterial pressure during maintenance. After surgical incision. The heart rate accelerated more in patients receiving isoflurane (p<0.05). During emergence, time of response to command was significantly shorter in patients receiving sevoflurane than patients receiving isoflurane (5.6 ± 0.4 min versus 15.2 ± 3.0min, p<0.001). Side effects such as nausea and vomiting were comparable in both groups. Conclusions: Compared with isoflurane, sevoflurane anesthesia had the clinical advantages of maintaining stable hemodynamics and rapid recovery in Chinese adult patients. |
本系統中英文摘要資訊取自各篇刊載內容。