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缺血性心脏病患者麻醉诱导和胸骨切开术期间的血流动力学稳定性。六种麻醉技术的比较。

Haemodynamic stability during anaesthesia induction and sternotomy in patients with ischaemic heart disease. A comparison of six anaesthetic techniques.

作者信息

Milocco I, Löf B A, William-Olsson G, Appelgren L K

出版信息

Acta Anaesthesiol Scand. 1985 Jul;29(5):465-73. doi: 10.1111/j.1399-6576.1985.tb02235.x.

Abstract

A comparison of haemodynamic stability with respect to arterial pressure, heart rate and cardiac output between six commonly used anaesthetic techniques: fentanyl (FE), halothane (HAL), morphine (MO), fentanyl/droperidol (NLA), and thiopentone (two dose levels: PE 3 and PE 6), all supplemented with nitrous oxide, was performed during induction of anaesthesia and sternotomy in 47 patients with good left ventricular function and maintained beta-blockers undergoing coronary bypass surgery. Interventions were kept to a minimum in order to characterize each anaesthesia group. Statistically, the material fell into two parts. The MO, PE 3 and PE 6 groups showed good stability under steady-state anaesthesia, but variable and often extensive hyperdynamic responses were seen to endotracheal intubation and surgical stimulation. The FE, HAL and NLA groups were characterized by a good stability during the induction-intubation phase but were unstable when combined with nitrous oxide in the absence of noxious stimuli.

摘要

在47例左心室功能良好且持续使用β受体阻滞剂、正在接受冠状动脉搭桥手术的患者中,于麻醉诱导期及胸骨切开术期间,对六种常用麻醉技术(芬太尼(FE)、氟烷(HAL)、吗啡(MO)、芬太尼/氟哌利多(NLA)以及硫喷妥钠(两个剂量水平:PE 3和PE 6),均辅以氧化亚氮)在动脉压、心率及心输出量方面的血流动力学稳定性进行了比较。为了描述每个麻醉组的特征,干预措施被保持在最低限度。从统计学角度来看,该材料分为两部分。MO、PE 3和PE 6组在稳态麻醉下表现出良好的稳定性,但气管插管及手术刺激时会出现多变且常为广泛的高动力反应。FE、HAL和NLA组的特点是在诱导 - 插管期稳定性良好,但在无有害刺激情况下与氧化亚氮联合使用时不稳定。

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