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老年患者异氟烷(福仑)麻醉期间的血流动力学与心肌氧耗量

Haemodynamics and myocardial oxygen consumption during isoflurane (forane) anaesthesia in geriatric patients.

作者信息

Tarnow J, Brückner J B, Eberlein H J, Hess W, Patschke D

出版信息

Br J Anaesth. 1976 Jul;48(7):669-75. doi: 10.1093/bja/48.7.669.

Abstract

The influence of isoflurane on haemodynamics and myocardial oxygen consumption was examined in seven geriatric patients under conditions of controlled ventilation and a normal arterial carbon dioxide tension. During isoflurane/nitrous oxide in oxygen anaesthesia (0.75 and 1.5 vol% inspired isoflurane) no significant changes occurred in cardiac output, stroke volume, heart rate, central venous and pulmonary artery pressure. Arterial pressure decreased, as did total peripheral resistance. A reduction in left ventricular maximum dp/dt (18-39%) was, at least in part, a result of changes in loading conditions. Total body (CaO2--CVO2) and base excess values remained within the normal range. We consider that the oxygen supply was adequate to meet the metabolic demands of the body as a whole. Myocardial oxygen consumption decreased by 25% during 0.75 vol% inspired isoflurane and by 43.5% with deepening of anaesthesia (1.5 vol% isoflurane).

摘要

在七名老年患者中,在控制通气和正常动脉二氧化碳分压的条件下,研究了异氟烷对血流动力学和心肌耗氧量的影响。在异氟烷/氧化亚氮吸入麻醉(吸入异氟烷浓度为0.75%和1.5%)期间,心输出量、每搏输出量、心率、中心静脉压和肺动脉压均无显著变化。动脉压下降,总外周阻力也下降。左心室最大dp/dt降低(18%-39%),至少部分是负荷条件变化的结果。全身(CaO2-CVO2)和碱剩余值仍在正常范围内。我们认为,氧气供应足以满足整个身体的代谢需求。在吸入0.75%异氟烷时,心肌耗氧量降低了25%,随着麻醉加深(吸入1.5%异氟烷),心肌耗氧量降低了43.5%。

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