Kling D, Russ W, Boldt J, Hempelmann G
Anasth Intensivther Notfallmed. 1987 Jun;22(3):128-32.
The haemodynamic effects of 70%, 50% and 30% N2O--compared to 100% O2--were studied in 20 patients undergoing coronary artery bypass grafting. The measurements-performed after an equilibration phase of 10 minutes--were made preoperatively but after induction of anaesthesia with 0.3 mg/kg bw etomidate, 0.01 mg/kg bw fentanyl and 0.1 mg/kg bw pancuronium bromide. In relation to N2O concentrations, mean arterial pressure (-4.8%), total systemic resistance (-7.9%) and stroke volume index (-6.4%) decreased moderately, whereas the cardiac index remained unchanged and the heart rate increased (+9.7). Total pulmonary vascular resistance was always within the physiological range, as were the triple index and the rate pressure product. In patients with coronary heart disease cardiovascular functions are compromised in close relation to the degree of the underlying disease. In accordance with other investigators, nitrous oxide should not be used in patients with impaired left ventricular function because of the possibility of deterioration of myocardial function. In such cases, amnesia should be achieved by means of other agents.
在20例接受冠状动脉搭桥术的患者中，研究了70%、50%和30%氧化亚氮与100%氧气相比的血流动力学效应。测量在10分钟的平衡期后进行，于术前、但在用0.3mg/kg体重依托咪酯、0.01mg/kg体重芬太尼和0.1mg/kg体重潘库溴铵诱导麻醉后进行。相对于氧化亚氮浓度，平均动脉压（-4.8%）、总全身阻力（-7.9%）和每搏量指数（-6.4%）适度降低，而心脏指数保持不变，心率增加（+9.7）。总肺血管阻力始终在生理范围内，三联指数和率压积也是如此。在冠心病患者中，心血管功能与基础疾病的严重程度密切相关。与其他研究者一致，由于存在心肌功能恶化的可能性，左心室功能受损的患者不应使用氧化亚氮。在这种情况下，应通过其他药物实现遗忘作用。
