不同浓度七氟醚麻醉对老年患者左心室功能的影响

发布时间：2018-04-12 18:42

本文选题：七氟醚 + 右心室功能　；参考：《临床麻醉学杂志》2016年09期

【摘要】：目的评价超声心动图下不同浓度七氟醚麻醉对老年患者左心室功能的影响。方法选择全麻下择期手术患者120例,男59例,女61例,年龄65~69岁,ASAⅠ或Ⅱ级,采用随机数字表法按最低肺泡有效浓度(MAC)将患者随机分为四组,每组30例。分别维持呼气末MAC值为1.0(S1组)、1.5(S2组)、2.0(S3组)、2.5(S4组),维持上述预定值10min后静脉注射芬太尼、琥珀胆碱快速诱导气管插管,机械通气,调整吸入浓度。于麻醉诱导前即刻(T0)、呼气末七氟醚浓度达到并维持在预定值3min(T1)、5min(T2)、8min(T3)、10min(T4)时采用心动超声记录左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室内径缩短率(LVFS)、心输出量(CO)。同时记录SBP、DBP、HR及吸入七氟醚期间心血管不良事件的发生情况。结果与T0时比较,T1~T4时四组SBP和DBP明显降低,T2~T4时S2、S3、S4组LVEF、LVFS和CO明显降低,S3、S4组LVESD明显升高(P0.05)。T2~T4时S2、S3、S4组LVEF、LVFS和CO明显低于S1组,S3、S4组LVESD明显高于S1组(P0.05)。T2时S3、S4组LVESD明显高于S2组(P0.05)。S1、S2组无一例低血压发生,S3、S4组分别发生6例(20%)和9例(30%)低血压,S3、S4组低血压发生率明显高于S1、S2组(P0.05)。结论低浓度七氟醚麻醉对老年患者左心室功能无明显影响,而高浓度七氟醚麻醉对左心室收缩功能有明显抑制作用,但对舒张功能无明显影响。
[Abstract]:Objective to evaluate the effects of sevoflurane anesthesia on left ventricular function in elderly patients.Methods one hundred and twenty patients (59 males and 61 females) undergoing elective operation under general anesthesia were randomly divided into four groups (30 cases in each group).The MAC value at the end of the breath was maintained in the 1.0(S1 group and the 1.0(S1 group respectively. The concentration of fentanyl was rapidly induced by succinylcholine after intravenously injection of fentanyl, mechanical ventilation, and the concentration of inhaled fentanyl was adjusted after maintaining the predefined value of 10min.The short rate is LVFS, the cardiac output is COG.At the same time, the occurrence of adverse cardiovascular events during SBP DBP HR and sevoflurane inhalation was recorded.The incidence of hypotension in S3 + S4 group was significantly higher than that in S1 / S 2 group (P 0. 05%) and that in S3 + S4 group was significantly higher than that in S3 + S4 group (6 / 20) and 9 / 30) hypotension group respectively (P < 0. 05).Conclusion low concentration sevoflurane anesthesia has no significant effect on left ventricular function in elderly patients, while high concentration sevoflurane anesthesia has obvious inhibitory effect on left ventricular systolic function, but has no obvious effect on diastolic function.
【作者单位】：苏州大学附属第二医院麻醉科;
【分类号】：R614.2

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