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目的：探讨地氟醚环路内注药法用于循环紧闭吸入麻醉的可行性，并观察地氟醚药代动力学的变化。方法：５０例ＡＳＡⅠ～Ⅱ级择期手术全麻病人，咪唑安定、芬太尼麻醉诱导插管行ＩＰＰＶ。氧流量４Ｌ／ｍｉｎ通气５分钟，行最低流量循环紧闭吸入麻醉。根据Ｌｏｗｅ的吸收公式，通过呼气端注入地氟醚的初始剂量，接着用微泵持续输入地氟醚，维持地氟醚的肺泡浓度（ＦＡ）约３％左右，术中根据地氟醚的ＦＡ调整输注速度。切皮前静注芬太尼０１ｍｇ，术中维库溴铵维持肌松，并辅以异丙酚２ｍｇ·ｋｇ－１·ｈ－１。记录地氟醚ＦＡ达３％的时间、呼气末浓度／吸气浓度（ＦＩ）达０８５的时间及其变化趋势。结果：地氟醚用量１０２４±１６３ｍｌ，地氟醚ＦＡ达３％的时间为１１±０４分钟，ＦＡ／ＦＩ达０８５的时间为３１±０１分钟，并能维持于０８５～０９５，恢复呼吸为５７±１３分钟，拔管时间为８３±０９分钟，睁眼时间８６±１６分钟。结论：采用低流量循环紧闭环路内注药法能安全有效地实施麻醉和减少环境污染。
Objective: To investigate the feasibility of intradermal injection of desflurane in anesthesia with closed-loop inhalation and to observe the pharmacokinetics of desflurane. Methods: Fifty ASA Ⅰ ~ Ⅱ patients undergoing general anesthesia were anesthetized with midazolam and fentanyl to induce IPPV. Oxygen flow 4L / min ventilation for 5 minutes, the line minimum flow cycle closed inhalation anesthesia. According to Lowe’s absorption formula, the initial dose of desflurane was injected through the expiratory end, and then the desflurane was continuously infused with a micro-pump to maintain the alveolar concentration (FA) of desflurane at about 3%. According to the FA Adjust infusion rate. Pentaplatin before intravenous injection of fentanyl 0 1mg, intraoperative vecuronium to maintain muscle relaxation, supplemented with propofol 2mg · kg-1 · h-1. Desflurane FA recorded 3% of the time, end-expiration / inspiratory concentration (FI) up to 0 85 time and its changing trend. Results: Desflurane dosage was 1024 ± 163ml, desflurane FA was 3% for 11 ± 04 minutes, FA / FI was 085 for 31 ± 01 Minutes, and can be maintained at 085 ~ 095, resumed breathing was 5 7 ± 1 3 minutes, extubation time was 8 3 ± 0 9 minutes, eyes open time of 8 6 ± 1 6 minutes . CONCLUSIONS: The use of a low-flow rate, closed-loop, bolus injection approach safely and effectively anesthesia and reduce environmental pollution.