军事医学2011，Vol.35Issue(10)：780-783,4.
七氟烷和丙泊酚诱导对老年患者血流动力学的影响
Evaluation of cardiac function of elderly patients with digestive system surgical procedures during different anesthesia induction
摘要
Abstract
Objective To compare the effect of sevoflurane and propofol in anesthesia induction on the cardiac output ( CO ) and stroke volume( SV ) among elders with digestive system surgical procedures, estimated by hemodynamic indexes from FloTrac/Vigileo device. Accordingly, in order to provide references for the choice of the optimal anesthesia induction method. Methods Forty ASA( American Society of Anesthesiologists ) Ⅱ patients aged 60 to 75 years and undergoing elective digestive system surgical procedures were randomly divided into two groups: sevoflurane( S ) group( Ⅰ )and propofol ( P ) group( Ⅱ ). In group S, tachy-induced anesthesia was facilitated with 8% sevoflurane inhalation while group P was induced with propofol ( by target control injection, TCI ) 3 |xg/ml. BIS was maintained at 50 - 45 through sevoflurane inhalation and propol TCI concentration regulated 20 min after induction. The mean arterial pressures MAP ), heart rate( HR ), and SV were routinely monitored. Stroke volume variation( SW ) was monitored soon after anesthesia induction by Flotrac/ Vigileo device. All indexes were recorded before anesthesia( T0 ), BIS down to 60( T, ), before intubation( T2 ), after intu-bation( T3 ), 1 min,3 min,5min,10 min, 15 min and 20 min after intubation ( T4-9 ). Results CO: Compared with the base value, CO fell to the lowest level before intubation. CO was decreased greatly in group S( P<0.05 ). SV: Compared with the base value, SV was decreased greatly in group P( P <0. 05 ) but soon turned to a stable level 5 min after intubation in group S and at 10 min in group P. MAP: Compared with the base value, MAP was decreased in the two groups after intubation. It was significantly recovered at 1 min after intubation in group S,and then decreased again in the two groups. It turned to a stable level at 5 min after intubation in group S and 10 min in group P. It was decreased greatly in group P( P < 0. 05 ). HR:Compared with the base value, HR was slowed after induction in the two groups, decreased by 12. 1% in group S before intubation. It was increased by 7. 5% at 1 min after intubation but turned to stable level at 5 min after intubation in the two groups. Compared to group P,HR was decreased greatly in group S( P <0. 05 ). SW remained higher in group P. Conclusion From induction of anesthesia to intubation of digestive system surgical procedures on elderly patients, sevoflu-rane represses circulation more effectively than propofol. During maintenance anesthesia,20 min after intubation, CO,SV,and MAP are all decreased in the two groups,but it takes sevofurane less time to return to normal than propofol.关键词
老年病学/胃肠肿瘤/外科手术/甲醚类/丙泊酚/血流动力学Key words
geriatrics/ gastrointestinal neoplasms/ surgical procedures/ methyl ethers/ propofol/ hemodynamics分类
医药卫生引用本文复制引用
李超,王勇,宋子贤,王合梅,雍芳芳,赵伟,贾慧群..七氟烷和丙泊酚诱导对老年患者血流动力学的影响[J].军事医学,2011,35(10):780-783,4.基金项目
河北省普通高等学校强势特色学科肿瘤学建设经费资助项目[冀教高(2005)52] （2005）
