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目的 采用经食道多普勒连续心输出量监测仪 (TECO1)测量地氟醚对小儿血液动力学的影响并与安氟醚进行比较 ,为临床合理选用麻醉药提供参考。方法 2 8例择期行会阴及骨科矫形手术 1～ 5岁小儿 ,ASAⅠ～Ⅱ级 ,快速诱导插管后随机分为吸入地氟醚 (D组 )和安氟醚 (E组 )两组。用TECO1分别测量呼出气体麻醉药浓度为 0、0 5、1 0和 1 5MAC稳定 5min后的SVI、CI及HR ,同时监测SP、DP及MAP。结果 与吸入麻醉药前相比 ,两者在 0 5MAC均引起相似幅度的轻度血压下降 ,CI、SVI及HR无明显改变。 1 0MAC时D组CI明显升高 ,并高于E组 ;D组HR及SVI增高与基础值比无统计学差别 ,但明显高于E组 ;两组血压均进一步下降 ,但幅度无差别。 1 5MAC时 ,E组的CI及SVI明显降低 ,而D组则无明显变化 ;D组HR增快 ,与E组有明显差别 ;两组血压进一步降低 ,E组MAP和SP下降幅度明显大于D组 ,DP无差别。结论 地氟醚与安氟醚相比可以更好的维持小儿的血液动力学的稳定
Objective To determine the effect of desflurane on pediatric hemodynamics by using TECO1 and compare with enflurane to provide a reference for the rational selection of anesthetics. Methods Twenty-eight pediatric patients aged 1 to 5 years who underwent orthopedic and orthopedic surgery were randomly divided into inhaled desflurane group (D group) and enflurane group (E group). Measure the SVI, CI, and HR with exhaled gas anesthesia at 0,05,1 0 and 1 5 MACs for 5 min with TECO1, and SP, DP and MAP at the same time. Results Compared with the pre-inhalation anesthetics, both at 0 5MAC caused a slight decrease in mild blood pressure with similar amplitude, while CI, SVI and HR did not change significantly. At 10MAC, the CI of D group was significantly higher than that of E group. The increase of HR and SVI in group D was not statistically different from the basal value, but significantly higher than that in E group. The blood pressure of both groups decreased further, but with no difference in amplitude. At 15MAC, the CI and SVI in group E were significantly lower than those in group D, while the changes in group D were not obvious. The HR in group D was faster than that in group E, and the levels of MAP and SP in group E were significantly lower than those in group D Group, DP no difference. Conclusion Desflurane is better than enflurane in maintaining hemodynamic stability in children