ĐÁNH GIÁ TÁC ĐỘNG CỦA GÂY MÊ DÒNG TỐI THIỂU VỚI DESFLURAN LÊN THỜI GIAN THOÁT MÊ VÀ LƯỢNG TIÊU THỤ KHÍ MÊ TRÊN BỆNH NHÂN PHẪU THUẬT CỘT SỐNG THẮT LƯNG

Abstract

Objective: To compare the time of wash-out, and desflurane consumption during low-flow and minimal-flow anesthesia in patients undergoing lumbar spine surgery. Students and methods: Prospective, clinical intervention, randomized controlled study, at Department of Anesthesia 2, Viet Duc Hospital, from April 2024 to June 2024. 70 patients with ASA I-II (age > 18yo), undergoing lumbar spine surgery. Wash-in with 6% desfluran, fresh gas flow 6 L min⁻¹. When the MAC value 0,8 and BIS decreased 40, fresh gas flow was reduced, group 1 with low flow 1 L min⁻¹, group 2 with minimal flow 0.5 L min⁻¹, adjust the concentration of desflurane to reach BIS 40-60, FiO₂ 60%. At the end of surgegy, the vaporizer off, the fresh gas 6 L min⁻¹. Extubation was carreed out, TOF > 0,9. Results: The average wash-out time of the low-flow and minimal-flow desflurane anesthsia was not different: time to reach 0.3MAC 4,08±1,33 min vs 4,14±1,41min; Eye opening time 6,62±1,34min vs 6,52±1,47min; tracheal extubation time 8,86±1,30min vs 9,02±1,46min. The amount of desflurane consumed during the maintenance phase of anesthesia in the low-flow group was 18.0±1.4ml hr ^-1, nearly double that of the minimal-flow group at 9.7±0.8ml hr ^-1. Conclusion: The wash-out time of the low flow and minimal flow desflurane anesthesia was similar, while the desflurane consumption of the low flow was almost twice as high as that of the minimal flow.