硬膜外阻滞与异氟醚复合麻醉对体循环和肝脏血流动力学的影响  

Effects of epidural block combined with isoflurane inhalation on systemic and hepatic hemodynamics.

作　　者：李士通[1] 庄心良[1] 徐国辉[1] 陆惟俊[1] 陈武荣[1] 

机构地区：[1]上海市第一人民医院麻醉科

出　　处：《上海医学》1998年第12期694-696,共3页Shanghai Medical Journal

摘　　要：目的：探讨硬膜外阻滞与异氟醚吸入复合麻醉对体循环和肝脏血流动力学的影响。方法：选用健康杂种犬１０只行胸段硬膜外阻滞后吸入０５和１０肺泡最低有效浓度（ＭＡＣ）异氟醚，监测体循环、肺循环、肝动脉、门静脉血流动力学，肝血流用电磁血流仪测定。结果：硬膜外阻滞后心率、血压、门静脉血流下降；加吸异氟醚后，随吸入浓度增加，心率、血压、心排血量、门静脉和肝动脉血流等逐步下降。１０ＭＡＣ时平均动脉压下降约４１％，肝动脉血流下降１５％，门静脉血流下降３５％。结论：硬膜外阻滞后，随异氟醚浓度升高，体循环、肺循环、肝动脉。Objective: To explore the effects of epidural block combined with isoflurane inhalation on systemic, pulmonary and hepatic hemodynamics. Methods: Systemic, pulmonary and hepatic hemodynamics were studied in 10 healthy mongrel dogs anesthetized with epidural block combined with 0 5 or 1 0 MAC isoflurane inhalation. Blood flow of hepatic artery and portal vein were monitored continuously with electromagnetic flowmeter. Results: HR, MAP and portal vein blood flow decreased significantly after epidural block. Combined with isoflurane HR, MAP, CO, hepatic artery and portal vein blood flow decreased progressively. With 1 0 MAC of isoflurane, MAP decreased 41%, hepatic artery blood flow 15% and portal vein blood flow 35%. Conclusion : Epidural block combined with higher concentration of isoflurane inhalation causes disturbance of systemic, pulmonary and hepatic hemodynamics.

关 键 词：肝血流 硬膜外麻醉 异氟醚 复合麻醉 

分 类 号：R614.27[医药卫生—麻醉学] R331.1[医药卫生—外科学]