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氟烷麻醉下由阿法沙龙或硫喷妥钠诱导的显微喉镜检查期间心电图变化的比较。

Comparison of electrocardiographic changes during microlaryngoscopy under halothane anaesthesia induced by althesin or thiopentone.

作者信息

Saarnivaara L, Kentala E

出版信息

Acta Anaesthesiol Scand. 1977;21(1):71-9. doi: 10.1111/j.1399-6576.1977.tb01197.x.

Abstract

The incidences of electrocardiographic (ECG) changes during microlaryngoscopy under halothane anaesthesia were compared by using Althesin and thiopentone as induction agents. During the procedure the most common ECG change in both groups was junctional rhythm, which occurred in 37% of the patients in the Althesin group and in 29% of the patients in the thiopentone group. The next most common changes in the Althesin group were: ventricular ectopic beats (22%), ischaemic S-T segment depression (14%), and T wave flattening or inversion (14%); those in the thiopentone group were ventricular ectopic beats (18%) and rapidly ascending S-T segment depression (12%). As well as during the procedures, some ECG changes were registered in both groups during intubation. ECG changes disappeared without any special treatment after manipulation of the vocal cords or after intubation. There was no statistically significant difference in the total incidence of dysrhythmias between the Althesin and thiopentone groups, but the types of dysrhythmias were different in the two groups. There were more lower nodal rhythms, less serious ectopic beats and more ischaemic S-T segment depression in the Althesin group than in the thiopentone group. The results suggest that Althesin is useful and superior to thiopentone in patients with a tendency to develop serious ventricular ectopic beats, whereas in patients with heart and coronary arterial disease, Althesin is inferior to thiopentone and should be used with care.

摘要

采用阿法沙龙和硫喷妥钠作为诱导剂,比较了氟烷麻醉下显微喉镜检查期间心电图(ECG)变化的发生率。在该过程中,两组最常见的心电图变化均为交界性心律,阿法沙龙组37%的患者出现,硫喷妥钠组29%的患者出现。阿法沙龙组其次常见的变化为:室性早搏(22%)、缺血性S-T段压低(14%)以及T波低平或倒置(14%);硫喷妥钠组为室性早搏(18%)和快速上升的S-T段压低(12%)。除了在操作过程中,两组在插管期间也记录到了一些心电图变化。声带操作或插管后,心电图变化无需特殊治疗即可消失。阿法沙龙组和硫喷妥钠组心律失常的总发生率无统计学显著差异,但两组心律失常的类型不同。阿法沙龙组比硫喷妥钠组有更多的低位结性心律、更不严重的异位搏动和更多的缺血性S-T段压低。结果表明,对于有发生严重室性早搏倾向的患者,阿法沙龙有用且优于硫喷妥钠,而对于患有心脏和冠状动脉疾病的患者,阿法沙龙不如硫喷妥钠,应谨慎使用。

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