非体外循环冠状动脉旁路移植术的麻醉和围术期管理  

ANESTHESIA AND PERIOPERATIVE MANAGEMENT OF OFF - PUMP CORONARY ARTERY BYPASS GRAFTING

作　　者：高秀江[1] 王莉[1] 周长浩[1] 毛瑞芬[1] 

机构地区：[1]河北医科大学第一医院麻醉科,河北省石家庄市050031

出　　处：《中国心血管病研究》2003年第1期26-28,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨非体外循环冠状动脉旁路移植术(OPCAB)的麻醉和围术期管理。方法 择期OPCAB患者18例,ASA分级Ⅲ～Ⅳ级,采用咪达唑仑、依托咪酯、普鲁泊福、芬太尼、维库溴铵、异氟烷等行常温静吸复合全麻。术中应用硝酸甘油、艾司洛尔、去氧肾上腺素、尼卡地平、山莨菪碱。结果18例手术均在非体外循环下完成,围术期循环稳定,无麻醉并发症,所有患者均痊愈出院。结论 OPCAB的麻醉和围术期管理的关键在于维持心肌氧供需的平衡,避免加重心肌缺血,同时要维持血液动力学平稳。Objective To investigate the anesthesiaand perioperative management of off - pump coronary artery bypass grafting (OPCAB) . Methods 18 ASA Ⅲ - Ⅳ adult patients were anesthetized by midazolam, etomidate, propofol, fentanyl, vecuronium and isoflurane in atmospheric temperature. Nitro-glycerin, esmolol, noradrenaline, nicardipine, anisodamine were used during operation. Results OPCAB were performed on the 18 patients, who were all cured with no anesthetic side effects. Conclusion The key of anesthesia and perioperative management of off - pump coronary artery bypass grafting is to maintain the equilibrium among myocardial oxygenic supply and oxygenic consuming and hemodynam-ics stability , and to avoid the aggravation of myocardial ischemia.

关 键 词：冠状动脉旁路移植术 麻醉 围术期 OPCAB 体外循环 ECC 并发症 

分 类 号：R654.2[医药卫生—外科学]