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单剂量丙泊酚对心室功能良好的冠心病患者的心血管效应

[Cardiovascular effects of a single dose of propofol in coronary patients with good ventricular function].

作者信息

Pensado A, Molins N, Alvarez J

机构信息

Servicio de Anestesiología y Reanimación, Hospital Xeral de Galicia, Santiago de Compostela, La Coruña.

出版信息

Rev Esp Anestesiol Reanim. 1994 May-Jun;41(3):147-51.

PMID:7914708
Abstract

OBJECTIVES

To determine the cardiovascular effects of a single dose of propofol in coronary patients with good ventricular function.

PATIENTS AND METHODS

Propofol 2 mg/kg-1 was administered to twenty coronary patients during dissection of the internal mammary artery in myocardial revascularization surgery. Heart rate (HR), systolic and diastolic systemic and pulmonary arterial pressure (SAP, DAP, SPAP and DPAP), central venous pressure, pulmonary capillary wedge pressure, cardiac output (CO), right ventricular ejection fraction, systemic and pulmonary vascular resistances (SVR and PVR), right and left ventricular stroke work index (RVSWI and LVSWI), rate-pressure product (RPP) and pressure-rate quotient (PRQ) were recorded prior to (baseline) and at 1, 3, 5, 10, 15, 20 and 30 min after administration of the drug.

RESULTS

One minute after administration of the drug there was a maximum decrease in SAP (-26%), DAP (-17%), SVR (-22%), RVSWI (-23%), RPP (-24%) and PRQ (-22%) (p < 0.001 in all cases) and this continued to be significant throughout the study for SAP, DAP and RPP, and for SVR, RVSWI and PRQ at times 15, 3 and 10, respectively. There were no significant changes in HR, CO, ventricular filling pressures and the remaining variables during the study.

CONCLUSIONS

Propofol produces the greatest decrease in systemic arterial pressure 1 min after administration and this decrease was maintained during the 30 min that our study lasted, due to a decrease in SVR but not in CO or in ventricular filling pressures.

摘要

目的

确定单剂量丙泊酚对心室功能良好的冠心病患者的心血管影响。

患者与方法

在心肌血运重建手术中,对20例冠心病患者在解剖乳内动脉时给予2mg/kg-1的丙泊酚。在给药前(基线)以及给药后1、3、5、10、15、20和30分钟记录心率(HR)、收缩压和舒张压、体循环和肺动脉压(SAP、DAP、SPAP和DPAP)、中心静脉压、肺毛细血管楔压、心输出量(CO)、右心室射血分数、体循环和肺血管阻力(SVR和PVR)、左右心室每搏功指数(RVSWI和LVSWI)、心率血压乘积(RPP)和压力心率商(PRQ)。

结果

给药后1分钟,SAP(-26%)、DAP(-17%)、SVR(-22%)、RVSWI(-23%)、RPP(-24%)和PRQ(-22%)出现最大降幅(所有情况下p<0.001),在整个研究过程中,SAP、DAP和RPP持续显著下降,SVR、RVSWI和PRQ分别在15、3和10分钟时持续显著下降。在研究过程中,HR、CO、心室充盈压和其余变量无显著变化。

结论

丙泊酚给药后1分钟时体循环动脉压下降最大,且在我们研究持续的30分钟内该降幅持续存在,这是由于SVR降低而非CO或心室充盈压降低所致。

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