Kellow N H, Scott A D, White S A, Feneck R O
Department of Anaesthesia, London Chest Hospital.
Br J Anaesth. 1995 Nov;75(5):578-82. doi: 10.1093/bja/75.5.578.
I.v. anaesthetic agents, including propofol, have not been shown to inhibit hypoxic pulmonary vasoconstriction (HPV). This may encourage the use of propofol in thoracic surgery where one lung ventilation (OLV) is required. We have compared the effects of maintaining anaesthesia with either isoflurane or propofol infusion on right ventricular function and shunt fraction. We studied 10 patients who received isoflurane and 12 who received propofol. When OLV commenced there was a greater reduction in both mean cardiac index (3.2 (SEM 0.2) to 2.4 (0.1) litre min-1 m-2 for propofol, and 3.4 (0.2) to 3.3 (0.4) litre min-1 m-2 for isoflurane) and right ventricular ejection fraction (0.45 (0.03) to 0.37 (0.02) for propofol, and 0.48 (0.02) to 0.42 (0.02) for isoflurane) in patients who received propofol. Furthermore, these reductions were sustained for longer in the propofol group. However, propofol was not associated with a significant increase in shunt fraction during OLV, which increased threefold in patients who received isoflurane.
静脉麻醉药，包括丙泊酚，尚未被证明能抑制缺氧性肺血管收缩（HPV）。这可能会促使丙泊酚在需要单肺通气（OLV）的胸外科手术中使用。我们比较了使用异氟烷或丙泊酚输注维持麻醉对右心室功能和分流分数的影响。我们研究了10例接受异氟烷麻醉的患者和12例接受丙泊酚麻醉的患者。当开始OLV时，接受丙泊酚麻醉的患者平均心脏指数（丙泊酚组从3.2（标准误0.2）降至2.4（0.1）升·分钟⁻¹·米⁻²，异氟烷组从3.4（0.2）降至3.3（0.4）升·分钟⁻¹·米⁻²）和右心室射血分数（丙泊酚组从0.45（0.03）降至0.37（0.02），异氟烷组从0.48（0.02）降至0.42（0.02））下降幅度更大。此外，丙泊酚组这些下降持续的时间更长。然而，丙泊酚在OLV期间与分流分数的显著增加无关，而接受异氟烷麻醉的患者分流分数增加了三倍。
