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目的 观察地氟醚对老年病人血液动力学的影响。方法 择期老年手术病人 30例 ,ASAⅠ～Ⅱ级。硫喷妥钠、琥珀胆碱、芬太尼诱导插管后 ,经口插入经食管多普勒心输出量测定仪。观察不同MAC地氟醚对老年病人的CO、PV、HR、FTC、CVP、CI、MAP、SVR的影响。结果 与吸入前相比 ,MAP、SVR在 1 0MAC、1 5MAC及 2 0MAC时显著下降 (P <0 0 5或 0 0 1) ,HR、FTC在 0 5MAC时无明显变化 (P >0 0 5 ) ,在 1 0MAC、1 5MAC及 2 0MAC时显著增加 (P <0 0 5或 0 0 1) ,CVP在 0 5MAC、1 0MAC、1 5MAC及 2 0MAC时明显升高 (P <0 0 5或 0 0 1) ,CO、PV、CI在 0 5MAC、1 0MAC、1 5MAC及 2 0MAC时均无显著性差异 (P >0 0 5 )。结论 地氟醚对心血管系统影响较小 ,由于老年病人代偿能力下降 ,在 1 0MAC以上浓度时 ,应注意维持血液动力学的稳定。
Objective To observe the effect of desflurane on hemodynamics in elderly patients. Methods Elective elderly patients in surgery 30 cases, ASA Ⅰ ~ Ⅱ grade. Thiopental sodium, succinylcholine, fentanyl induced intubation, the oral insertion of transesophageal Doppler cardiac output detector. The effects of different desflurane on CO, PV, HR, FTC, CVP, CI, MAP and SVR in elderly patients were observed. Results MAP and SVR decreased significantly at 10MAC, 15MAC and 20MAC compared with that before inhalation (P <0 05 or 0 0 1). HR and FTC had no significant change at 0 5MAC (P 0 05 ) Significantly increased at 10MAC, 15MAC and 20MAC (P <0 05 or 0 0 1). CVP was significantly increased at 0 5MAC, 1 0MAC, 1 5MAC and 20MAC (P <0 05 or There was no significant difference in CO, PV and CI between 0 5MAC, 1 0MAC, 1 5MAC and 2 0MAC (P 0 05). CONCLUSION: Desflurane has little effect on cardiovascular system. Due to the declining capacity of elderly patients, hemodynamic stability should be maintained at concentrations above 10MAC.