Combes P, Payen J F, Durand M, Magne J L, Pra Y
Département d'anésthésie-réanimation 1., Hôpital A. Michallon, Grenoble.
Can J Anaesth. 1989 Nov;36(6):658-64. doi: 10.1007/BF03005417.
Thirteen patients requiring infrarenal aortic clamping were studied during flunitrazepam, fentanyl, pancuronium and nitrous oxide anaesthesia. Each awake patient was submitted to a volume loading test to determine the haemodynamic status and his optimal left pre-load. Anesthetic induction was well tolerated. Nitroglycerin was administered by continuous infusion before aortic clamping and we determined the dose necessary to decrease the systemic vascular resistance by 20 per cent. This dose was very variable and needed to be increased in five of 13 patients at the time of clamping. With nitroglycerin, we noticed no significant alteration of MVO2 at clamping. Volume loading allowed good stability at declamping.
对13例需要进行肾下主动脉钳夹的患者在氟硝西泮、芬太尼、泮库溴铵和一氧化二氮麻醉期间进行了研究。每位清醒患者均接受容量负荷试验,以确定血流动力学状态和最佳左心室前负荷。麻醉诱导耐受性良好。在主动脉钳夹前持续输注硝酸甘油,并确定将体循环血管阻力降低20%所需的剂量。该剂量变化很大,13例患者中有5例在钳夹时需要增加剂量。使用硝酸甘油时,我们注意到钳夹时MVO2无明显改变。容量负荷使松开钳夹时保持良好的稳定性。