Myles P S, Storer R, Millar C
Anaesthetic Department, Royal Perth Hospital, Western Australia.
Anaesth Intensive Care. 1992 Feb;20(1):21-7. doi: 10.1177/0310057X9202000104.
We measured haemodynamic effects and uptake of enflurane in patients undergoing cardiac surgery utilizing a standard anaesthetic technique of fentanyl 15 mcg/kg nitrous oxide 50%/enflurane 1%. We divided 22 patients preoperatively into two groups according to standard criteria: good and poor myocardial function. Regression lines could be drawn illustrating the relationship of cardiac output and uptake (at 1 minute: r = -0.56, P less than 0.01; at 5 minutes: r = -0.43, P less than 0.05; at 30 minutes: r = -0.31, P = 0.08). Although patients with poor myocardial function had decreased uptake of enflurance (approximately 10-20%), this did not reach statistical significance. Fentanyl/nitrous oxide/enflurane anaesthesia provided stable haemodynamics, even in patients with poor myocardial function. Both groups had a shunt fraction of approximately 10% and an arterial: end-tidal carbon dioxide difference of approximately 3-4 mmHg.
我们采用芬太尼15微克/千克、氧化亚氮50%/恩氟烷1%的标准麻醉技术，测量了心脏手术患者的血流动力学效应和恩氟烷摄取量。术前，我们根据标准标准将22例患者分为两组：心肌功能良好组和心肌功能较差组。可以绘制回归线来说明心输出量与摄取量之间的关系（1分钟时：r = -0.56，P<0.01；5分钟时：r = -0.43，P<0.05；30分钟时：r = -0.31，P = 0.08）。尽管心肌功能较差的患者恩氟烷摄取量有所下降（约10%-20%），但未达到统计学意义。芬太尼/氧化亚氮/恩氟烷麻醉即使在心肌功能较差的患者中也能提供稳定的血流动力学。两组的分流分数均约为10%，动脉血与呼气末二氧化碳分压差值约为3-4 mmHg。
