单肺通气期间肺动静脉分流及缺氧性肺血管收缩对动脉血七氟烷浓度的影响  

作　　者：Shinji Matsuse, MD Yoshiki Hara, MD Takako Ohkura, PhD 邱郁薇(译) 徐关英(校) 

机构地区：[1]Department of Anesthesia, Kasukabe-chuo General Hospital, Kasukabe, Japan [2]Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan [3]Department of Clinical Development, Maruishi Pharmaceutical Co., Ltd., Osaka, Japan [4]不详

出　　处：《麻醉与镇痛》2013年第5期60-63,共4页Anesthesia & Analgesia

摘　　要：七氟烷因其血气分配系数低、起效及消除迅速而被广泛应用于临床麻醉。尽管单肺通气（one—lungventilation，OLV）期间连续吸入恒定浓度的七氟烷，但临床上仍有一些患者会出现不自主体动、心动过速和高血压，提示可能存在麻醉深度不足。我们观察到1例患者在OLV期间出现动脉血七氟烷浓度及脉搏血氧饱和度同时一过性显著下降。尽管吸入和呼出的七氟烷浓度保持稳定，但由于动脉血的七氟烷浓度低于预期值可能会导致单肺通气期间麻醉深度不足。Sevoflurane is widely used for its rapid onset and offset due to a lower blood/gas coefficient. However, involuntary movements, tachycardia, and hypertension have been observed in some patients despite a continuing constantly delivered concentration of sevoflurane during I-lung ventilation （OLV）, indicating the possibility of insufficient depth of anesthesia. We observed a temporary but obvious decrease in arterial sevoflurane concentration and pulse oximeter readings in a patient during OLV. This may have resulted in the depth of inhaled anesthesia being insufficient during OLV because the arterial sevoflurane concentration was lower than expected in spite of constantly delivered and inspiratory/expiratory sevoflurane concentrations.

关 键 词：单肺通气期间 缺氧性肺血管收缩 七氟烷 动脉血 肺动静脉分流 浓度 脉搏血氧饱和度 血气分配系数 

分 类 号：R614[医药卫生—麻醉学]