洗入高浓度七氟醚麻醉诱导对低龄婴儿心功能的影响  

Effect of high concentration sevoflurane wash-in in induction of anesthesia on cardiac function in young inrants

作　　者：庄菁[1] 吕晶[1] 乔伟[2] 任卫东[2] 孙震[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳市110004 [2]中国医科大学附属盛京医院超声科,沈阳市110004

出　　处：《中华麻醉学杂志》2012年第8期912-915,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价洗入高浓度七氟醚麻醉诱导对低龄婴儿心功能的影响。方法择期行体表血管瘤切除术婴儿，28—60d龄，ASA分级I级，按体重3．0—3．4kg、3．5～3．9kg、4．0—4．4h、4．5～4．9kg、5．O～5．4kg、5．5—5．9kg、6．0—6．4kg、6．5—6．9kg分为8个区组，每一区组3例患儿，采用随机数字表法，将其随机分为3组（n=8）：吸入6％、7％和8％七氟醚麻醉诱导组（s，组、S2组和S3组）。吸人七氟醚进行麻醉诱导，分别于吸入七氟醚前（基础状态，T1）和吸入七氟醚4min时（L）采用心脏超声多普勒技术测定每搏量（Sv）、左心室舒张末期容积（LVEDV）、射血分数（EF）、每搏指数（sI）、心率（HR）、心输出量（CO）、心指数（cI）、二尖瓣环后间隔侧左心室快速充盈期心肌组织运动峰速度（Ea）、二尖瓣环后间隔侧左心室在心房收缩期心肌组织运动峰速度（Aa）、Ea与Aa的比值（Ea／Aa）、二尖瓣环后间隔侧收缩期心肌组织运动峰速度（Sa）和Tei指数。结果与，I．1时比较，3组T2时Sv、EF、SI、Ea／Aa和Tei指数均升高，HR、Ea、Aa和sa降低（P〈0．05），而LVEDV、CO和cI差异无统计学意义（P〉0．05）；与S，组比较，S2组和s3组Tei指数升高（P〈0．05），其余指标差异无统计学意义（P〉0．05）；S2组和s3组心功能指标差异无统计学意义（P〉0．05）。结论洗入6％、7％、8％七氟醚麻醉诱导对低龄婴儿心功能无明显影响，3种浓度七氟醚均可用于临床。Objective To evaluate the effect of the high concentration of sevoflurane wash-in in induction of anesthesia on the cardiac function in young infants. Methods ASA I young infants, aged 28-60 days, underg- oing resection of hemangioma on body surface under general anesthesia, were studied. According to the principle of randomized block design, 8 blocks were designed based on the body weight （3.0-3.4 kg, 3.5-3.9 g, 4.0-4.4 kg, 4.5-4.9 kg, 5.0-5.4 kg, 5.5-5.9 kg, 6.0-6.4 kg, 6.5-6.9 kgi, with 3 infants in each block. The infants were randomly divided into 3 groups （ n = 8 each） ： anesthesia induction with 6 %, 7 % and 8 % sevoflurane groups （ groups $1_3 ） ~ In groups $1.3, the infants inhaled 6 %, 7 % and 8 % sevoflurane respectively for induction of anes- thesia. Transthoracic echocardiographic examinations were performed before sevoflurane inhalation （baseline, T~ ） and at 4 min of sevoflurane inhalation （I＂2） to record the stroke volume （ SV）, left ventricle end-diastolic volume （LVEDV）, ejection fraction （EF）, stroke volume index （SI）, heart rate （HR）, cardiac output （CO）, cardiac in- dex （CI）, peak early diastolic velocity of mitral annulus （Ea）, peak late diastolic velocity of mitral annulus （Aa）, peak systolic velocity of mitral annulus （Sa）, and Tei index. The mitral annulus peteroseptal Ea/Aa （Ea/Aa） was calculated. Results Compared with the baseline value, SV, EF, SI, Ea/Aa and Tei index were significantly in- creased, HR, Sa, Ea and Aa were significantly decreased （ P 〈 0.05 ）, and no significant change was found in LVEDV, CO and CI at 4 min of sevoflurane inhalation in groups S1-3 （ P 〉 0.05）. Tei index was significantly higher in groups S2,3 than in group S1 （P 〈 0.05）. There was no significant difference in the parameters of cardiac function between group S2 and group S3 （ P 〉 0.05 ）. Conclusion 6 %, 7 % and 8 % sevofiurane wash-in in in- duction of anesthesia exert no effect on the cardiac function in young infa

关 键 词：麻醉药 吸入 婴儿 新生 心脏功能试验 

分 类 号：R726.1[医药卫生—儿科]