七氟醚与丙泊酚麻醉对心内直视手术患者应激反应的影响  

Effect of sevoflurane and propofol on stress response in patients undergoing open heart surgery

作　　者：胡义凤[1] 张利东[2] 罗伟[2] 李伟彦[2] 

机构地区：[1]无锡市第二人民医院麻醉科,214002 [2]南京军区南京总医院麻醉科

出　　处：《临床麻醉学杂志》2012年第4期346-348,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较七氟醚吸入麻醉与丙泊酚静脉麻醉对心内直视手术患者CPB期间应激反应的影响。方法择期行心脏直视手术患者40例,ASAⅡ或Ⅲ级,随机均分为七氟醚组(S组)和丙泊酚组(P组)。记录诱导前(T0)、气管插管后5min(T1)、CPB后30min(T2)、CPB结束(T3)、术毕(T4)MAP、HR、BIS及血浆促肾上腺皮质激素(ACTH)和皮质醇(Cor)含量。结果与T0时比较,T1时两组MAP、BIS、ACTH、Cor均降低(P<0.05),T2～T4时ACTH、Cor均明显升高(P<0.01)。T2、T3时P组MAP、BIS、ACTH、Cor显著高于S组(P<0.05)。结论心内直视手术CPB期间七氟醚吸入麻醉较之丙泊酚静脉麻醉可显著降低机体应激反应。Objective To investigate the effect of sevoflurane anesthesia and propofol anesthesia on endocrine stress response in patients undergoing open heart surgery during cardiopulmonary bypass（CPB）.Methods Forty ASA Ⅱ or Ⅲ patients were randomly allocated to one of two groups（n=20）：sevoflurane anesthesia group（group S） and propofol anesthesia group（group P）.MAP,HR,BIS,plasma concentration of adrenocorticotropic hormone（ACTH） and cortisol（Cor）,were recorded before induction（T0）,at 5 min after intubation（T1）,at 30 min after the initiation of CPB（T2）,at the end of CPB（T3） and operation（T4）.Results Compared with T0,MAP,HR,BIS,and levels of ACTH and Cor,decreased significantly at T1（P 〈 0.05） while ACTH and Cor increased significantly at T2-T4（P 〈 0.01） in both groups.MAP,BIS,and levels of ACTH and Cor,in group P were significantly higher than those in group S at T2-T3（P 〈 0.05）.Conclusion Sevoflurane inhalation anesthesia can more effectively inhibit the stress response in patients undergoing open heart operation during CPB than propofol anesthesia.

关 键 词：七氟醚 丙泊酚 心肺转流 应激反应 

分 类 号：R614[医药卫生—麻醉学]