异丙酚或依托咪酯复合硬膜外阻滞对血流动力学和肝氧供的影响  

The Effects of Epidural Block Combined with Propofol or Etomidate on Hemodynamics, Hepatic Blood Flow and Oxygen Delivery

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

机构地区：[1]上海市第一人民医院麻醉科

出　　处：《临床麻醉学杂志》1999年第3期158-160,共3页Journal of Clinical Anesthesiology

摘　　要：目的：探讨硬膜外阻滞与异丙酚或依托咪酯复合麻醉对血流动力学和肝血流及氧供的影响。方法：选用健康杂种犬２２只行胸段硬膜外阻滞后，随机分为两组，分别静脉注射异丙酚２５ｍｇ／ｋｇ（ｎ＝１２）或依托咪酯０４ｍｇ／ｋｇ（ｎ＝１０），监测１０分钟内体循环、肝动脉、门静脉血流动力学及肝脏氧供。结果：硬膜外阻滞后ＨＲ、ＭＡＰ、ＳＶＲ、门静脉血流和氧供下降；异丙酚诱导后ＨＲ、ＭＡＰ、ＳＶＲ降低，ＣＯ也于２～５分钟时下降；依托咪酯诱导后各参数无进一步明显变化。两组肝动脉血流和氧供始终维持稳定。结论：硬膜外阻滞后应用异丙酚诱导对血流动力学影响虽较依托咪酯强，但两组肝血流和氧供均能维持。Objective: To explore the effects of epidural block combined with intravenous propofol or etomidate on hemodynamics, hepatic blood flow and oxygen delivery. Methods: Systemic and hepatic hemodynamics, oxygen delivery were studied in 22 healthy montgrel dogs anesthetized with epidural block combined with introvenous bolus of propofol 25mg/kg or etomidate 04mg/kg. Results: HR, MAP, SVR, portal vein blood flow and oxygen delivery decreased significantly after epidural block. Combined with introvenous propofol, HR, MAP, SVR decreased further and CO decreased 2 to 5 minutes after propofol. Etomidate did not cause significant change of hemodynamic parameters. Hepatic artery blood flow and oxygen delivery were not changed significantly after epidural block as well as after either combined anesthesia. Conclusion: Combined with epidural block, propofol causes more significant disturbance of systemic hemodynamics than etomidate. But the hepatic blood flow and oxygen delvery are kept stable in two groups.

关 键 词：异丙酚 依托咪酯 硬膜外麻醉 血流动力学 

分 类 号：R614.42[医药卫生—麻醉学] R971.2[医药卫生—外科学]