Hempelmann G, Seitz W, Piepenbrock S, Meixner P, Schaps D, Schleussner E
Anaesthesist. 1982 Mar;31(3):103-10.
In 93 cardiac patients the effects of low, mean and high fentanyl dosage--0.003 mg/kg, 0.015 mg/kg and 0.03 mg/kg--on haemodynamics, inotropic state and myocardial oxygen consumption were investigated during surgical procedures under basic neuroleptanalgesia. There was an increase in heart rate with the low fentanyl dosage, whereas mean and high doses lowered heart rate. Decreases in arterial pressure, left ventricular pressure, and perfusion pressure during extracorporal circulation as well are interpreted as peripheral vasodilatory effects. Most of the measured and calculated hemodynamic parameters such as PAP, dp/dtmax, CI, TSR decreased. There was, however, no decrease in myocardial contractility, when considering changes in heart rate, pre- and after-load and dp/dtmax. The decrease in heart work and myocardial oxygen consumption may be of advantage especially in patients with coronary heart disease.
在93例心脏手术患者中,研究了低剂量、中等剂量和高剂量芬太尼(分别为0.003mg/kg、0.015mg/kg和0.03mg/kg)在基础神经安定镇痛下手术过程中对血流动力学、心肌收缩状态和心肌耗氧量的影响。低剂量芬太尼使心率增加,而中等剂量和高剂量则降低心率。体外循环期间动脉压、左心室压力和灌注压的下降也被解释为外周血管舒张作用。大多数测量和计算的血流动力学参数如肺动脉压(PAP)、最大dp/dt、心脏指数(CI)、总外周阻力(TSR)均下降。然而,考虑到心率、前负荷和后负荷以及最大dp/dt的变化,心肌收缩力并未下降。心脏做功和心肌耗氧量的降低可能对尤其是冠心病患者有利。