Bell J, Sartain J, Wilkinson G A, Sherry K M
Northern General Hospital, Sheffield.
Anaesthesia. 1995 Jul;50(7):644-8. doi: 10.1111/j.1365-2044.1995.tb15122.x.
Total intravenous anaesthesia with propofol and fentanyl was used in 23 patients undergoing coronary artery and 16 patients undergoing valve surgery and the haemodynamic effects in the two groups were compared. Baseline values showed that the valve surgery group had a higher mean heart rate, pulmonary artery wedge pressure and pulmonary artery pressure and smaller mean stroke volume than the coronary artery surgery group. In both groups, heart rate, arterial pressure, pulmonary artery wedge pressure, pulmonary artery pressure and cardiac index decreased during surgery. In the valve surgery group there were greater percentage decreases in heart rate, mean arterial pressure and diastolic arterial pressure. Overall, propofol and moderate-dose fentanyl anaesthesia was no more detrimental to the haemodynamics in patients undergoing valve surgery when compared to those undergoing coronary artery surgery.
23例接受冠状动脉手术的患者和16例接受瓣膜手术的患者采用丙泊酚和芬太尼全静脉麻醉,并比较两组的血流动力学效应。基线值显示,瓣膜手术组的平均心率、肺动脉楔压和肺动脉压高于冠状动脉手术组,平均每搏量低于冠状动脉手术组。两组患者在手术过程中心率、动脉压、肺动脉楔压、肺动脉压和心脏指数均下降。瓣膜手术组心率、平均动脉压和舒张压的下降百分比更大。总体而言,与接受冠状动脉手术的患者相比,丙泊酚和中剂量芬太尼麻醉对接受瓣膜手术的患者血流动力学的损害并不更大。