Biccard B M
Consultant Anaesthetist, Department of Anaesthetics, Nelson R Mandela School of Medicine, Private Bag 7, Congella, 4013, South Africa.
Anaesthesia. 2004 Jan;59(1):60-8. doi: 10.1111/j.1365-2044.2004.03455.x.
Patients with coronary artery disease presenting for major noncardiac surgery may have indications for both peri-operative beta-blockade and haemodynamic optimisation. The combination of peri-operative cardiorespiratory failure and myocardial ischaemia has a grave prognosis. Recent investigations have shown that in patients with coronary artery disease, beta-blockade does not depress cardiac output as much as originally thought. There may, therefore, be a place for both peri-operative beta-blockade and haemodynamic optimisation. The indications for peri-operative beta-blockade and haemodynamic optimisation, the effect of acute beta-blockade on cardiac output in patients with coronary artery disease, and the interaction of peri-operative beta-blockade and haemodynamic optimisation are discussed.
因重大非心脏手术前来就诊的冠心病患者可能同时有围手术期使用β受体阻滞剂和进行血流动力学优化的指征。围手术期心肺衰竭和心肌缺血并存预后严重。近期研究表明，在冠心病患者中，β受体阻滞剂对心输出量的抑制作用并不像最初认为的那么大。因此，围手术期使用β受体阻滞剂和进行血流动力学优化可能都有其意义。本文讨论了围手术期使用β受体阻滞剂和进行血流动力学优化的指征、急性β受体阻滞剂对冠心病患者心输出量的影响，以及围手术期使用β受体阻滞剂与血流动力学优化之间的相互作用。
