摘要: |
目的观察七氟烷和地氟烷吸入麻醉对非体外循环冠脉搭桥术(OPCABG)患者血流动力学和应激反应的影响。方法选择接受全身麻醉下OPCABG患者60例,年龄5174岁,BMI 2030kg/m2,ASA分级III级,随机分为七氟烷组(S组,n=30)和地氟烷组(D组,n=30)。两组常规静脉麻醉诱导后插入气管导管,S组患者调节七氟烷浓度为11.5 MAC;D组调节地氟烷浓度为11.5 MAC。在不同时间点:手术开始前(T0)、吻合血管前(T1)、吻合血管后(T2)、手术结束时(T3)和术后24小时(T4)记录血流动力学指标,并抽取血液标本进行皮质醇、胰岛素、肌酸激酶同功酶(CK-MB)和C反应蛋白(CRP)水平的检测。结果D组患者术中血压、心率与T0相比显著增加,差异有统计学意义(P<0.05)。两组患者皮质醇、胰岛素、CK-MB和CRP与T0相比显著增加,差异有统计学意义(P<0.05),但D组增加更为明显;组间比较,与D组相比S组患者:平均动脉压和心率在T1和T2显著降低,皮质醇和CK-MB水平在T1T4显著降低,差异有统计学意义(P<0.05),胰岛素和CRP水平差异无统计学意义(P>0.05)。结论七氟烷比地氟烷吸入麻醉在OPCABG患者能更好地控制血流动力学的变化和应激反应。 |
关键词: 七氟烷 地氟烷 非体外循环冠状动脉移植 血流动力学 应激 |
DOI: |
分类号: |
基金项目: |
|
Effects of Sevoflurane and Desflurane on Hemodynamics and Stress Reaction in Patients with Off-pump Coronary Artery Bypass Grafting |
Wang Han;Wu Zhichao;Bao Xiaohang1,2
|
1.Department of Anesthesiology in Nanchong Central Hospital;2.Department of Anesthesiology,Xinqiao Hospital,Third Military Medical University
|
Abstract: |
Objective To observe the effects of sevoflurane and desflurane inhalation anesthesia on hemodynamics and stress reaction in patients with off-pump coronary artery bypass grafting(OPCABG).MethodsA total of 60 patients with OP-CABG undergoing general anesthesia,age 5174 years,BMI 20 to 30kg/m2,ASA grade III grade,were randomly divided into sevoflurane group(S group,n=30)and desflurane group(D group,n=30).Two groups of patients were inserted into tracheal tube after routine intravenous anesthesia induction.The concentration of sevoflurane in group S was 1 to 1.5 MAC,and the concentration of desflurane in group D was 1 to 1.5 MAC.Hemodynamic index was recorded and blood samples were collected for cortisol,insulin,creatine kinase isoenzyme(CK-MB)and C reaction protein(CRP)were detection at different time points:before the start of surgery(T0),before vascular anastomosis(T1),after vascular anastomosis(T2),at the end of operation(T3)and 24 hours after operation(T4).Results The blood pressure and heart rate in operation of the patients in the D group were significantly increased compared with the T0,and the difference was statistically significant(P<0.05).The level of cortisol,insulin,CK-MB and CRP of the patients in the two groups were significantly increased compared with the T0,and the difference was statistically significant(P<0.05),but the D group was more obvious;comparison between groups,compared with the D group,the mean arterial pressure and heart rate decreased significantly in the T1and T2,cortisol and CK-MB levels in T1T4were significantly decreased in the S group,the difference was statistically significant(P<0.05),and there was no statistically significant differences in insulin and CRP levels(P>0.05).ConclusionCompared with desflurane,sevoflurane inhaled anaesthesia can better control changes in hemodynamics and stress reaction in OPCABG patients |
Key words: sevoflurane desflurane off-pumpcoronaryarterybypassgrafting hemodynamics stressreaction |