七氟醚吸入麻醉下开胸手术患者围麻醉期体温的变化  

Changes of Core and Peripheral Surface Temperatures in Patients Undergoing Thoracotomy During Sevoflurance Inhaling Anesthesia

作　　者：阳兴[1] 黄漫[1] 卓兆麒[1] 

机构地区：[1]广东省江门市中心医院麻醉科,广东江门529070

出　　处：《中外医疗》2010年第11期102-103,106,共3页China & Foreign Medical Treatment

摘　　要：目的观察七氟醚吸入麻醉下开胸手术患者围麻醉期体温度的变化。方法择期行开胸手术患者67例,ASAI～Ⅱ级,采用七氟醚麻醉。以鼻咽温度代表中心温度,臂-指温度差表示血管收缩程度,体表温度通过Ramanatyan公式计算。观察诱导前、诱导后即刻、15、30、45、60、90、120、150、180min,停药时、停药后5、10、15、20min的温度、全身耗氧量和产热量的变化。结果与诱导前比较,患者耗氧量和产热量在诱导后15min到停药后10min时均降低,耗氧量和产热量在停药20min时升高,诱导后30～180min时体表温度升高(P<0.05);与停药时比较,停药后15、20min时耗氧量、停药后20min产热量增加(P<0.05);与诱导后即刻比较,中心温度在诱导后90min到停药后20min时降低(P<0.05);平均臂-指温度差在诱导后即刻由>0℃降低到<0℃,停药时又升为>0℃。结论七氟醚吸入麻醉开胸手术患者围麻醉期中心温度降低,与体表温度升高、耗氧量和产热量降低有关。Objective To investigate changes of core and peripheral surface temperatures in patients undergoing thoracotomy during sevoflurance inhaling anesthesia,and influencea of systemic oxygen consumption（SOC） and metabolic heat production（MHP）on core temperatures.Methods Sixty-seven ASA I～Ⅱ patients undergoing selective thoracotomy were anesthetized with sevoflurance inhaling anesthesia.Nasopharyngeal temperatures were measured as core temperature,and forearm-fingertip temperature gradients as marks of peripheral vasodilation and vasoconstriction.Peripheral surface temperature was calculated according to the Ramanatyan formula.All temperatures,oxygen consumption and metabolic heat production were measured at following points：before induction,0,15,30,45,60,90,120,150,180min after induction,immediately,5,10,15and20min after stopping of isoflurane infusion.Results Along with deepening of anesthesia,core temperature,SOC,MHP markedly lowered,average body surface temperature increased markedly,Peripheral surface temperature obviously rose,and forearm-fingertip temperature gradients decreased from0℃ to0℃.After stopping of isoflurane infusion,core temperature,SOC and MHP and forearm-fingertip temperature gradients greatly increased,and peripheral surface temperature markedlowered.Conclusion The decrease of core temperature during sevoflurance inhaling anesthesia is associated with increase of peripheral surface temperature and decrease of SOC and MHP.

关 键 词：七氟醚 吸入麻醉 体温 

分 类 号：R614[医药卫生—麻醉学]