20例冠状动脉搭桥术的麻醉处理体会  

Anesthetic management experience of 20 cases of coronary artery bypass grafting

作　　者：刘书杰 廖轶铭 翟春丽 唐小娜 单玉迪 LIU Shu-jie;LIAO Yi-ming;ZHAI Chun-li(Huludao Second People’s Hospital,Huludao 125000,China)

机构地区：[1]辽宁省葫芦岛市第二人民医院,125000

出　　处：《中国实用医药》2022年第3期126-128,共3页China Practical Medicine

摘　　要：目的总结冠状动脉搭桥手术麻醉处理的临床效果。方法20例择期行冠状动脉搭桥手术的患者,以舒芬太尼麻醉方式为主,并选用保护心肌功能的异丙酚及咪唑安定,七氟烷静吸复合维持术中镇静,比较患者麻醉前后血压指标变化情况、心率及脑电双频指数(BIS)。结果麻醉后收缩压(112.36±3.36)mm Hg(1 mm Hg=0.133 kPa)、舒张压(63.36±3.25)mm Hg均低于麻醉前的(150.52±2.25)、(90.25±2.25)mm Hg,差异有统计学意义(P<0.05)。麻醉后患者心率(69.02±0.58)次/min、BIS(42.36±1.36)均低于麻醉前的(98.12±0.26)次/min、(86.36±3.36),差异有统计学意义(P<0.05)。结论麻醉手术的首要任务,应是防止心肌缺氧缺血,防止脑缺血缺氧,因此在麻醉前确保充分供氧,维持镇静,进行麻醉时应力求血液动力学保持平稳,在围手术期内适当使用扩张血管的药物,降低心脏负荷。Objective To summarize the clinical effect of coronary artery bypass grafting.Methods In 20 patients undergoing elective coronary artery bypass grafting,sufentanil anesthesia was the main method,and propofol and midazolam were selected to protect myocardial function,and sevoflurane intravenous inhalation was combined to maintain intraoperative sedation.The changes of blood pressure index,heart rate and bispeetral index(BIS)before and after anesthesia were compared.Results After anesthesia,the systolic blood pressure(112.36±3.36)mm Hg(1 mm Hg=0.133 kPa)and diastolic blood pressure(63.36±3.25)mm Hg were lower than(150.52±2.25)and(90.25±2.25)mm Hg before anesthesia,and the difference was statistically significant(P<0.05).After anesthesia,the heart rate(69.02±0.58)beats/min and BIS(42.36±1.36)were lower than(98.12±0.26)beats/min and(86.36±3.36)before anesthesia,and the difference was statistically significant(P<0.05).Conclusion The primary task of anesthesia surgery should be to prevent myocardial hypoxia and ischemia and prevent cerebral ischemia and hypoxia.So we should ensure sufficient oxygen supply before anesthesia,maintain sedation,strive to maintain stable hemodynamics during anesthesia,and properly use vasodilators during perioperative period to reduce cardiac load.

关 键 词：冠状动脉搭桥术 麻醉 血压 心率 

分 类 号：R614[医药卫生—麻醉学]