Beck D H, Doepfmer U R, Sinemus C, Bloch A, Schenk M R, Kox W J
Universitätsklinik Charité, Abteilung für Anaesthesiologie und operative Intensivmedizin, Berlin, Germany.
Br J Anaesth. 2001 Jan;86(1):38-43. doi: 10.1093/bja/86.1.38.
Forty patients requiring one-lung ventilation (OLV) for thoracic surgery were randomly assigned to receive propofol (4-6 mg kg(-1) h(-1)) or sevoflurane (1 MAC) for maintenance of anaesthesia. Three sets of measurements were taken: (i) after 30 min of two-lung ventilation (TLV), (ii) after 30 min of one-lung ventilation (OLV-1) in the supine position and (iii) during OLV in the lateral position (OLV-2) with the chest open and before surgical manipulation of the lung. There were no differences between groups in patient characteristics or preoperative condition. Increases in shunt fraction during OLV-1 were 17.4% and 17.2% (P=0.94), those during OLV-2 were 18.3% and 16.5% (P=0.59) for the propofol and sevoflurane group, respectively. Cardiac index and other haemodynamic and respiratory variables were similar for the two groups. We conclude that inhibition of hypoxic pulmonary vasoconstriction by sevoflurane may only account for small increases in shunt fraction and that much of the overall shunt fraction during OLV has other causes.
40例需要在胸外科手术中进行单肺通气（OLV）的患者被随机分配接受丙泊酚（4 - 6 mg·kg⁻¹·h⁻¹）或七氟醚（1 MAC）用于维持麻醉。进行了三组测量：（i）双肺通气（TLV）30分钟后，（ii）仰卧位单肺通气（OLV - 1）30分钟后，以及（iii）侧卧位且胸腔打开并在对肺进行手术操作前的单肺通气（OLV - 2）期间。两组患者的特征或术前状况无差异。丙泊酚组和七氟醚组在OLV - 1期间分流分数的增加分别为17.4%和17.2%（P = 0.94），在OLV - 2期间分别为18.3%和16.5%（P = 0.59）。两组的心脏指数及其他血流动力学和呼吸变量相似。我们得出结论，七氟醚对低氧性肺血管收缩的抑制作用可能仅导致分流分数的小幅增加，并且OLV期间总体分流分数的大部分有其他原因。
