Hempelmann G, Seitz W, Schleussner E, Piepenbrock S
Anaesthesist. 1981 Aug;30(8):390-6.
In 52 patients with acquired heart disease haemodynamic effects of 0,2 mg/kg and 1,0 mg/kg morphine were investigated during surgical procedures under neuroleptanalgesia. The following parameters were measured or calculated: heart rate (HR), arterial pressure (Part, Psyst, Pdiast), pulmonary artery pressure (PAP), right (PRA) and left atrial pressure (PLA), left ventricular pressure (PLV), left ventricular end-diastolic pressure (PLVED), left ventricular peak dp/dt (dp/dtmax), cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke index (SI), total systemic resistance (TSR), total pulmonary resistance (TPR), work index of the right (RVWI) and left ventricle (LVWI). Myocardial oxygen consumption (EG) was calculated according to the method of Bretschneider. There was almost no change in cardiac index and stroke index. In comparison to a control group (n=36) morphine caused a dose-dependent decrease in arterial pressure and in arterial perfusion pressure during extracorporeal circulation. This, however, was mainly attributable to vasodilatation and not to a negative inotropic effect. In accordance with the changes in haemodynamics there was a remarkable decrease in myocardial oxygen consumption (EG: -21.1%; 1,0 mg/kg morphine).
在52例获得性心脏病患者中，研究了在神经安定镇痛下手术过程中0.2mg/kg和1.0mg/kg吗啡的血流动力学效应。测量或计算了以下参数：心率（HR）、动脉压（Part、Psyst、Pdiast）、肺动脉压（PAP）、右心房压（PRA）和左心房压（PLA）、左心室压（PLV）、左心室舒张末期压（PLVED）、左心室dp/dt峰值（dp/dtmax）、心输出量（CO）、心脏指数（CI）、每搏量（SV）、每搏指数（SI）、总全身阻力（TSR）、总肺阻力（TPR）、右心室作功指数（RVWI）和左心室作功指数（LVWI）。心肌耗氧量（EG）根据布雷tschneider方法计算。心脏指数和每搏指数几乎没有变化。与对照组（n = 36）相比，吗啡在体外循环期间导致动脉压和动脉灌注压呈剂量依赖性下降。然而，这主要归因于血管舒张，而非负性肌力作用。与血流动力学变化一致，心肌耗氧量显著下降（EG：-21.1%；1.0mg/kg吗啡）。
