Mask Inhalation Anesthesia with Sevoflurane for Gynecologic Ambulatory Surgery

Sevoflurane面罩式吸入麻醉在婦産科門診手術之應用

金承惠(Chen-Hui Chin) ； 詹景全(Chying-Chyuan Chan)

《北市醫學雜誌》 2卷1期 (2005/01) Pp. 48-53

https://doi.org/10.6200/TCMJ.2005.2.1.08

摘要

背景：sevoflurane不具刺激氣味且有低血氣分割系數，適用於吸入性誘導麻醉，在門診手術病人使用這快睡易醒而安全的麻醉藥品，減少病人在開刀房及恢復室的時間，而且術後之惡心，嘔吐亦罕見，是一個理想的門診手術麻醉藥。方法：我們收集了50位，年齡21至84歲之婦女， ASA class Ⅰ~Ⅱ在本院接受婦科門診常規手術之病人，以sevoflurane 8%及O2(8 L/min) 吸入性誘導麻醉，將麻醉維持濃度在1-1.5 MAC 之間，全部手術在適當麻醉深度下完成，沒有任何併發症。記錄病人之麻醉誘導時間，病人甦醒時間及麻醉併發症，恢復室恢復狀況，及追蹤術後惡心嘔吐情形。結果：41位(82%)病人於1分鐘左右完成麻醉誘導，術後3分鐘左右甦醒，平均67.8分鐘離開醫院，其它9位病人其甦醒時間雖然長(3.1minutes vs 15.8minutes)，但在手術時間及恢復情形並無差異。術後僅4%病人在24小時後有惡心但無嘔吐之情形。結論：sevoflurane符合門診手術易睡快醒少術後不適的原則，是適合使用於門診手術的麻醉方式。

關鍵字

面罩式麻醉 ； sevoflurane ； 門診手術

並列摘要

Objective: Sevoflurane has many advantages: rapid induction and emergence profiles, and a low incidence of side effects. It is suitable to be used for outpatient surgery. In this study, we evaluated the anesthetic profiles of sevoflurane alone for mask anesthesia for minor gynecologic ambulatory surgery. Methods: In total, 50 ASA class I-Il women, aged 21 to 84 years, undergoing gynecologic ambulatory surgery were included. All of them received 8% sevoflurane plus 8 L/min 02 for mask inhalation induction, and the anesthesia was maintained with 1~1.5-fold of the minimum alveolar concentration (MAC) by mask inhalation. We measured the times to induction, emergence, recovery of mental orientation, and discharge. lncidences of postoperative nausea and vomiting were record. Results: Mask anesthesia with sevoflurane was provided to all patients, and all completed the surgical operation uneventfully. Forty-one (82%) of 50 patients awakened within 5 mm, and the induction, emergence, orientation, and discharge times were 57±28.7 s, 3.1±1.7, 4.4±7.6 and 67.8±11.9 min, respectively. Nine patients were awakened late with an emergence time of 15.8±9.8 min, but there was no difference in the recovery data. All patients were discharged within±2 h. Conclusions: Mask anesthesia with sevoflurane is a good choice of clinical anesthesia for ambulatory surgery.

並列關鍵字

mask anesthesia ； sevoflurane ； ambulatory surgery