Chraemmer-Jørgensen B, Høilund-Carlsen P F, Marving J, Pedersen J F
Anesthesiology. 1985 Mar;62(3):278-86. doi: 10.1097/00000542-198503000-00012.
Radionuclide cardiography with 99mTc-labeled erythrocytes was carried out in three different studies comprising 20 female patients without heart or lung diseases. Left ventricular ejection fraction (LVEF) and other hemodynamic variables were measured immediately before and during induction of anesthesia (thiopental, N2O/O2, succinylcholine, laryngoscopy + oral intubation, halothane). In study 1, serial measurements of LVEF, left ventricular volume, and derived variables were obtained by gamma camera in seven patients using 3-min sampling periods. In Studies 2 and 3, LVEF was monitored serially in seven and six patients, respectively, by a portable, nonimaging probe (nuclear stethoscope) at 1-min intervals or less. The induction period was prolonged to last 24 min in studies 1 and 2, against 9 min in study 3. In studies 1 and 2 there was an increase in blood pressure and heart rate after thiopental and after laryngoscopy and intubation. In study 3 a similar increase was observed after intubation. In the gamma camera study LVEF decreased from 0.72 to 0.53 after thiopental, with no further decrease during intubation. This decrease was accompanied by an increase in end-systolic volume and a decrease in the ratio: systolic cuff pressure/end systolic volume, whereas end-diastolic volume and cardiac index remained unchanged. In the nuclear stethoscope studies, LVEF decreased both after thiopental and after intubation, in study 2 from 0.68 to 0.38 and from 0.53 to 0.41, respectively; in study 3 from 0.69 to 0.53 and from 0.57 to 0.44, respectively. Our observation, in healthy, female individuals, provide an impetus for further noninvasive radionuclide studies during anesthesia in patients with cardiovascular disease.
在三项不同的研究中，对20名无心脏或肺部疾病的女性患者进行了99mTc标记红细胞的放射性核素心动图检查。在麻醉诱导前及诱导过程中（硫喷妥钠、N2O/O2、琥珀酰胆碱、喉镜检查 + 经口插管、氟烷），测量左心室射血分数（LVEF）和其他血流动力学变量。在研究1中，使用3分钟采样期，通过γ相机对7名患者的LVEF、左心室容积及派生变量进行了连续测量。在研究2和3中，分别使用便携式非成像探头（核听诊器）以1分钟或更短的间隔时间，对7名和6名患者的LVEF进行了连续监测。研究1和2中的诱导期延长至24分钟，而研究3中的诱导期为9分钟。在研究1和2中，硫喷妥钠给药后以及喉镜检查和插管后，血压和心率升高。在研究3中，插管后观察到类似的升高。在γ相机研究中，硫喷妥钠给药后LVEF从0.72降至0.53，插管过程中未进一步下降。这种下降伴随着收缩末期容积增加以及收缩压袖带压力/收缩末期容积比值降低，而舒张末期容积和心脏指数保持不变。在核听诊器研究中，硫喷妥钠给药后及插管后LVEF均下降，研究2中分别从0.68降至0.38以及从0.53降至0.41；研究3中分别从0.69降至0.53以及从0.57降至0.44。我们在健康女性个体中的观察结果，为进一步对心血管疾病患者进行麻醉期间的无创放射性核素研究提供了动力。
