摘要
目的 探讨帕瑞昔布钠对食管癌根治术患者单肺通气（OLV）时肺内分流的影响.方法 择期行食道癌根治术患者45例,年龄47～57岁,体重42～59kg,ASA分级Ⅰ或Ⅱ级,随机分为2组：生理盐水组（C组,n=23）和帕瑞昔布钠组（P组,n=22）.P组静脉注射帕瑞昔布钠40 mg（生理盐水稀释至10 ml）,C组静脉注射等容量生理盐水.随后两组均靶控输注异丙酚（效应室靶浓度4μg/m1）和舒芬太尼（效应室靶浓度0.3 ng/ml）行麻醉诱导,静脉注射罗库溴铵0.9 mg/kg,光纤支气管镜引导下插入双腔气管导管,行机械通气.于麻醉诱导开始后30 min（T0）、单肺通气15 min（T1）、30 min（T2）、1 h（T3）、恢复双肺通气30 min（T4）和1 h（T5）时测定CVP、HR、MAP和气道平均压（Pmean）,同时采集颈内静脉和桡动脉血样,进行血气分析,计算肺内分流率（Qs/Qt）.结果 与T0时比较,两组T1-3时Pmean 和Qs/Qt升高（P＜0.05）;与T1时比较,两组T2.3.时Qs/Qt降低（P＜0.05）;两组各时点Pmean、Qs/Qt、CVP、HR和MAP比较差异无统计学意义（P＞0.05）.结论 帕瑞昔布钠40 mg对食管癌根治术患者单肺通气时缺氧性肺血管收缩反应无影响.
Objective To investigate the effect of parecoxib on intrapulmonary shunt during one-lung yentilation in patients undergoing esophageal cancer operation. Methods Forty-five ASA Ⅰ orⅡ patients of both sexes aged 47-57 yr weighing 42-59 kg undergoing esophageal cancer resection were randomly divided into 2 groups：control group （group C,n = 23） and parecoxib group （group P,n = 22）. Left radial artery and right internal jugular vein were cannulated for MAP and CVP monitoring and blood sampling. Parecoxib 40 mg in 10 ml of normal saline was injected iv slowly before induction of anesthesia in group P while in group C normal saline 10 ml was injected instead of parecoxib. Anesthesia was induced with TCI of propofol （Ce 4 μg/ml） and sufentanil （Ce 0.3 ng/ml）. Insertion of double lumen tube was facilitated with rocuronium 0.9 mg/kg. Correct position of the double lumen tube was verified by fiberoptic bronchoscopy. Anesthesia was maintained with TCI of propofol and sufentanil and intermittent iv boluses of cis-atracurium. BIS was maintained at 50-55 during operation. MAP, HR, CVP,mean airway pressure were monitored and recorded after induction of anesthesia （To）, at 15, 30 min and 1 h of OLV （T1.2.3） and 30 min and 1 h after re-expansion of the collapsed lung （T4.5）. Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis. Intrapulmonary shunt （Qs/Qt） was calculated.Results There was no significant difference in MAP, HR, CVP, mean airway pressure and Qs/Qt during onelung ventilation between the two groups. Conclusion Parecoxib has no effect on hypoxic pulmonary vasoconstriction during one-lung ventilation in patients undergoing esophageal cancer resection.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2010年第11期1350-1352,共3页
Chinese Journal of Anesthesiology
关键词
环氧化酶2抑制剂
肺循环
肺通气
Cyclooxygenase 2 inhibitors
Pulmonary circulation
Pulmonary ventilation
