七氟醚和丙泊酚对老年冠心病患者麻醉诱导期心率变异性的影响  

Effects of sevoflurane and propofol on heart rate variability during induction of anesthesia in elderly patients with coronary artery disease

作　　者：欧晓峰[1] 郑宏[1] 叶建荣[1] 陈林[1] 华玉思[1] 

机构地区：[1]新疆医科大学第一附属医院麻醉科,乌鲁木齐市830011

出　　处：《临床麻醉学杂志》2011年第6期538-540,共3页Journal of Clinical Anesthesiology

基　　金：新疆维吾尔自治区科技支疆项目(编号:200991126)

摘　　要：目的观察七氟醚和丙泊酚对老年冠心病患者全麻诱导期心率变异性（HRV）的影响。方法40例择期行上腹部手术老年冠心病患者，年龄60-80岁，ASAⅡ或Ⅲ级，随机均分为七氟醚（S组）和丙泊酚（P组）：分别予4%七氟醚或靶控输注丙泊酚3μg／ml行麻醉诱导。分别记录麻醉前（基础值）、诱导后5、10、15、20minSBP、DBP、HR及HRV的变化。结果与麻醉前比较，诱导后5、10min两组SBP、DBP下降，HR减慢（P〈0．05）。诱导后5、15minP组SBP、DBP显著低于S组，P组HR快于S组（P〈0．05）。在麻醉诱导中，S组主要是低频（LF）逐渐降低，P组则是高频（HF）逐渐降低。结论与靶控输注丙泊酚麻醉比较，七氟醚吸入麻醉对血流动力学影响较轻，诱导相对平稳，更适合老年冠心病患者的麻醉诱导。Objective To investigate the effects of sevoflurane and propofol on heart rate variability（HRV） during induction of anesthesia in elderly patients with coronary artery disease. Methods Forty ASA Ⅱ-Ⅲ patients（aged 65-80） with coronary artery disease scheduled for elective surgery were randomly divided into sevoflurane group（S group） and propofol group（P group）, each of 20 ease. Patients in group S inhaled 40/oo sevoflurance; in group P, the target controlled induction concentration of propofol was 3 μg/ml. The hemodynamics and HRV were monitored at the time points of before induction（baesline）, and 5,10,15, 20 rain after intubation. Results Both group the SBP,DBP, HR were significantly lower than the baseline at the time points of 5, 10, 15 rain after induction（P〈0. 05）, in P group the SBP, DBP were significantly lower than those in group S, but the HR was significantly higher in group P. After the induction of anesthesia, the low frequency （LF） was mainly decreased in S group, while the high frequency （HF） was mainly decreased in P group. Conclusion Compare of taget propofol, induction of anesthesia with sevoflurane is less effect on hemodynamie in elderly coronary heart disease patients. Sevoflurane is more benefit than propofol for the induction of anesthesia with elderly coronary heart disease.

关 键 词：七氟醚 丙泊酚 老年 冠心病 麻醉诱导 心率变异性 

分 类 号：R614[医药卫生—麻醉学]