摘要
作者应用美国BoMed NCCOM_3无创伤监测仪对27例心脏手术病人于芬太尼—安定—氧麻醉下的血流动力学变化进行了研究。检测结果表明:(1)诱导剂量10和16μg/kg芬太尼,病人出现心率减慢,平均压下降;气管插管时:前者心率增快,后者血流动力学参数无明显变化。(2)给房缺(ASD)或室缺(VSD)病人30μg/kg芬太尼后 ,病人心率又减慢6～10%,心排血量减少30%,心肌收缩性轻度抑制;部分病人纵断胸骨时应激反应明显,而大剂量(50μg/kg)芬太尼,病人的应激反应较中等剂量(30μg/kg)时更为轻微。(3)对心脏瓣膜疾病的病人,注射大剂量芬太尼麻醉,病人以心率减慢最为显著,SV增加,CI不变,MAP下降,心肌收缩代偿性增强;纵断胸骨循环功能无明显变化。心电图上无心肌缺血改变。
Hemodynamic changes of 27 patients undergoing open-heart surgery during fentany-diazepam- oxygen anesthesia were studied with a BoMed NCCOM3 monitor.The results showed that, ( 1 ) 10 and 16μg/kg of fentanyl produced a significant decrease in MAP and reductionof HR,and endotracheal intubation induced asignificant increase of HR in the former and the latter did not markedly change any of the hemodynamic parameters in the latter. ( 2 ) After injecting 30μg/kg fentanyl into patients with ASD or VSD, Hr was reduced by 6-10% , CO decreased by 30% , the cardiac contractility was lightly depressed,and the stress response of a part of the patients in time of stemotmy was obvious,whilethe response to the large dose ( 50μg/kg ) was slightly than tothe medium ( 30μg/kg ) .( 3 ) After injecting a heavy dose of fentanyl anesthesia into those patients with cardiacvalve disease,the reduction of HR was the most pronunced,there appeared an increase of SV, no change of CI, a decrease in MAP and augmentation of myocardial contractility.In circulatory function after sternotomy there was no significant change. Myocardial ischemic changes were not found in electrocardiogram results.
出处
《赣南医学院学报》
1990年第1期17-21,66-67,共5页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
关键词
芬太尼
静脉麻醉
心脏手术
循环
Fentanyl/pharmacodynamics
Fentanyl/administration and dosage
Heart function tests
Anesthesia, intravenous/adverse effects
Intraoperative care/methods
Heart valve deseases/Surgery
Heart defects, Congenital/surgery.
