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[挥发性麻醉剂对人体心脏功能的抑制作用;基于收缩期时间间期的研究]

[Volatile anesthetics suppress cardiac function in man; an investigation based on systolic time intervals].

作者信息

Mutoh T

机构信息

Department of Anesthesiology, Nippon Medical School, Tokyo.

出版信息

Masui. 1993 Jan;42(1):83-90.

PMID:8433499
Abstract

Hemodynamic changes and left ventricular performance were investigated by simplified mechanocardiography using finger plethysmography instead of carotid artery pulse tracing in patients who received 4 volatile anesthetics with or without nitrous oxide. Systolic blood pressure (Ps), diastolic blood pressure (Pd), heart rate (HR), pre-ejection period (PEP), left ventricular ejection time (LVET), isovolemic contraction time (ICP), PEP/LVET, Pd/ICT, and 1/PEP2 were selected as indices which represent hemodynamics and systolic time intervals. Enflurane 0.6 and 1.2MAC prolonged PEP, and shortened 1/PEP2 and Pd/ICT significantly. Addition of nitrous oxide caused more depression. Halothane 0.6MAC prolonged PEP, and shortened 1/PEP2 and Pd/ICT. Sevoflurane 1.2MAC shortened only 1/PEP2. Addition of nitrous oxide prolonged PEP and PEP/LVET, and shortened Pd/ICT. Isoflurane 1.2MAC lowered Ps and increased HR. The results indicate that cardiac performance was depressed by volatile anesthetics in the order of enflurane, halothane, sevoflurane and isoflurane.

摘要

在接受4种挥发性麻醉剂(使用或不使用氧化亚氮)的患者中,通过简化的心机械图法(使用手指体积描记法而非颈动脉脉搏描记法)研究血流动力学变化和左心室功能。收缩压(Ps)、舒张压(Pd)、心率(HR)、射血前期(PEP)、左心室射血时间(LVET)、等容收缩时间(ICP)、PEP/LVET、Pd/ICT和1/PEP2被选为代表血流动力学和收缩时间间期的指标。0.6和1.2MAC的安氟醚显著延长PEP,缩短1/PEP2和Pd/ICT。添加氧化亚氮会导致更明显的抑制作用。0.6MAC的氟烷延长PEP,缩短1/PEP2和Pd/ICT。1.2MAC的七氟醚仅缩短1/PEP2。添加氧化亚氮会延长PEP和PEP/LVET,并缩短Pd/ICT。1.2MAC的异氟醚降低Ps并增加HR。结果表明,挥发性麻醉剂对心脏功能的抑制作用顺序为安氟醚、氟烷、七氟醚和异氟醚。

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