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[七氟醚与丙泊酚靶控输注对健康女性择期乳腺手术期间血流动力学的影响]

[Effects of sevoflurane versus target-controlled infusion of propofol on haemodynamics during elective breast surgery in healthy women].

作者信息

Łasińska-Kowara Magdalena, Kardel-Reszkiewicz Ewelina, Owczuk Radosław

机构信息

Klinika Anestezjologii i Intensywnej Terapii, Gdański Uniwersytet Medyczny, Gdańsk.

出版信息

Anestezjol Intens Ter. 2009 Jul-Sep;41(3):135-9.

Abstract

BACKGROUND

Haemodynamic changes during general anaesthesia are still being widely investigated. Although propofol and sevoflurane are commonly used anaesthetic agents, there is a lack of comparative studies assessing their influence on haemodynamic parameters. We have assessed whether the effects of target-controlled propofol anaesthesia on HR, MAP and cardiac output, are different from those seen with a sevoflurane-based protocol.

METHODS

ASA I and II females, scheduled for elective breast surgery, were studied. After premedication with midazolam and intravenous induction with propofol, fentanyl and vecuronium bromide, general anaesthesia was maintained with either 1 MAC sevoflurane in oxygen/air (group S), or a target-controlled infusion of 3 micromL(-1) propofol (group P). Both groups received additional fentanyl. Heart rates and mean arterial pressures were noted and compared. Stroke volumes, cardiac outputs and cardiac indexes were measured every 3 min, using a non-invasive carbon dioxide rebreathing method (NICO).

RESULTS

Fifty-seven patients were enrolled in the study. Comparisons between the groups revealed a significant decrease in mean heart rate during maintenance of anaesthesia with propofol (p<0.05), but not with sevoflurane. Although cardiac output and cardiac index were lower in group P towards the end of analysis, no statistically significant differences in HR, MAP, SV, CO or CI were found between the groups.

CONCLUSION

The haemodynamic effect of a target 3 micromL(-1) propofol infusion did not differ significantly from that observed with 1 MAC sevoflurane.

摘要

背景

全身麻醉期间的血流动力学变化仍在广泛研究中。尽管丙泊酚和七氟醚是常用的麻醉剂,但缺乏评估它们对血流动力学参数影响的比较研究。我们评估了靶控丙泊酚麻醉对心率、平均动脉压和心输出量的影响是否与基于七氟醚的方案不同。

方法

研究对象为计划进行择期乳房手术的美国麻醉医师协会(ASA)分级为I级和II级的女性患者。在给予咪达唑仑进行术前用药以及使用丙泊酚、芬太尼和维库溴铵进行静脉诱导后,一组患者使用氧气/空气混合气体中1最低肺泡有效浓度(MAC)的七氟醚维持全身麻醉(S组),另一组患者使用靶控输注3微克/毫升的丙泊酚维持全身麻醉(P组)。两组均额外给予芬太尼。记录并比较心率和平均动脉压。使用无创二氧化碳重呼吸法(NICO)每3分钟测量一次每搏量、心输出量和心脏指数。

结果

57例患者纳入本研究。组间比较显示,丙泊酚维持麻醉期间平均心率显著降低(p<0.05),而七氟醚维持麻醉期间则无此现象。尽管在分析末期P组的心输出量和心脏指数较低,但两组之间在心率、平均动脉压、每搏量、心输出量或心脏指数方面未发现统计学上的显著差异。

结论

靶控输注3微克/毫升丙泊酚的血流动力学效应与1 MAC七氟醚观察到的效应无显著差异。

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