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丙泊酚或异氟烷麻醉对接受射频导管消融治疗快速性心律失常的儿童心脏传导的影响。

Effects of propofol or isoflurane anesthesia on cardiac conduction in children undergoing radiofrequency catheter ablation for tachydysrhythmias.

作者信息

Lavoie J, Walsh E P, Burrows F A, Laussen P, Lulu J A, Hansen D D

机构信息

Department of Anesthesia, Children's Hospital, Boston, MA 02115, USA.

出版信息

Anesthesiology. 1995 Apr;82(4):884-7. doi: 10.1097/00000542-199504000-00010.

Abstract

BACKGROUND

To determine suitability for ablation procedures in children, two commonly used anesthetic agents were studied: propofol and isoflurane.

METHODS

Twenty patients presenting for a radiofrequency catheter ablation procedure were included and randomly assigned to two groups. A baseline electrophysiology study was performed during anesthesia with thiopental, alfentanil, nitrous oxide, and pancuronium in all patients. At the completion of the baseline electrophysiology study (EPS), 0.8-1.2% isoflurane was administered to patients in group 1 and 2 mg/kg propofol bolus plus an infusion of 150 micrograms.kg-1.min-1 was administered to patients in group 2. Nitrous oxide and pancuronium were used throughout the procedure. After 30 min of equilibration, both groups underwent a repeat EPS. The following parameters were measured during the EPS: cycle length, atrial-His interval, His-ventricle interval, corrected sinus node recovery time, AV node effective refractory period, and atrial effective refractory period. Using paired t tests, the electrophysiologic parameters described above measured during propofol or isoflurane anesthesia were compared to those measured during baseline anesthesia. Statistical significance was accepted as P < 0.05.

RESULTS

There was no statistically significant difference in the results obtained during baseline anesthesia when compared with those measured during propofol or isoflurane anesthesia.

CONCLUSIONS

Neither propofol nor isoflurane anesthesia alter sinoatrial or atrioventricular node function in pediatric patients undergoing radiofrequency catheter ablation, compared to values obtained during baseline anesthesia with alfentanil and midazolam.

摘要

背景

为确定儿童消融手术的适用性,对两种常用麻醉剂进行了研究:丙泊酚和异氟烷。

方法

纳入20例接受射频导管消融手术的患者,并随机分为两组。所有患者在硫喷妥钠、阿芬太尼、氧化亚氮和泮库溴铵麻醉期间进行了基线电生理研究。在基线电生理研究(EPS)完成后,第1组患者给予0.8 - 1.2%异氟烷,第2组患者给予2 mg/kg丙泊酚推注加150微克·千克⁻¹·分钟⁻¹的输注。整个手术过程中使用氧化亚氮和泮库溴铵。平衡30分钟后,两组均进行重复EPS。在EPS期间测量以下参数:周期长度、心房-希氏束间期、希氏束-心室间期、校正窦房结恢复时间、房室结有效不应期和心房有效不应期。使用配对t检验,将丙泊酚或异氟烷麻醉期间测量的上述电生理参数与基线麻醉期间测量的参数进行比较。统计学显著性以P < 0.05为标准。

结果

与丙泊酚或异氟烷麻醉期间测量的结果相比,基线麻醉期间获得的结果无统计学显著差异。

结论

与阿芬太尼和咪达唑仑基线麻醉期间获得的值相比,丙泊酚和异氟烷麻醉均不会改变接受射频导管消融的儿科患者的窦房结或房室结功能。

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