围体外循环期挥发麻醉药血/气分配系数的动态变化

首都医科大学学报 ›› 2004, Vol. 25 ›› Issue (1): 106-109.

围体外循环期挥发麻醉药血/气分配系数的动态变化

周建新¹, 刘进²

1. 首都医科大学附属北京天坛医院ICU;2. 四川大学华西医院麻醉学及危重病医学教研室

收稿日期:2003-09-05 修回日期:1900-01-01 出版日期:2004-01-15 发布日期:2004-01-15

Dynamic Changes in Blood/Gas Partition Coefficient of Volatile Anesthetics during Cardiopulmonary Bypass

Zhou Jianxin¹, Liu Jin²

1. Department of ICU, Beijing Tiantan Hospital, Affiliate of Capital University of Medical Sciences;2. Department of A Nesthesiology and CCM, West China Hopital, Sichuan University

Received:2003-09-05 Revised:1900-01-01 Online:2004-01-15 Published:2004-01-15

摘要/Abstract

摘要： 为观察围体外循环(CPB)期挥发麻醉药血/气分配系数(λ_B/G)的变化规律,选择6例接受瓣膜置换术的患者,分别于诱导前、切皮时、主动脉插管时、CPB复温开始时即刻、CPB停机时和缝皮时采集桡动脉血,并记录每个时点患者的肛温和红细胞比容。用2次平衡法同时测定地氟醚、异氟醚和氟烷在上述各时点的λ_B/G,测定温度为当时的肛温。发现:挥发麻醉药λ_B/G在围CPB期不同时点间存在显著性差异(P<0.05)。CPB停机和缝皮时的λ_B/G明显小于诱导前基础水平(P<0.05),而复温时的λ_B/G与诱导前基础值无显著性差异(P>0.05)。结果提示,挥发麻醉药λ_B/G在心血管麻醉围CPB期处于动态变化过程中,并受到患者体温和血液稀释的综合影响.

关键词: 挥发麻醉药, 血/气分配系数, 体外循环

Abstract: In order to determine and estimate blood/gas partition coefficient of volatile a nesthetics during open heart surgery, blood samples were obtained from six adult patients undergoing valvular replacement with hypothermic cardiopulmonary bypas s 6 times: before induction, skin incision, aortic cannulation, before rewarming during bypass, weaning of bypass and skin suture. Blood/gas partition coefficient of desflurane, isoflurane and halothane were measured simultaneousl y at rectal temperature when blood was sampled. Significant differences were fou nd in blood/gas partition coefficient of the three anesthetics between differen t times during operation (P<0.05). Blood/gas partition coefficient at weanin g of bypass was the lowest, about 75% of that before anesthesia induction. The r esults of this study indicate that blood/gas partition coefficients of volatile anesthetics vary dynamically during open heart surgery and they are influenced b y the combination of hypothermia and hemodilution.

Key words: volatile anesthetics, blood/gas partit ion coefficient, cardiopulmonary bypass

中图分类号:

R614.2

周建新;刘进. 围体外循环期挥发麻醉药血/气分配系数的动态变化[J]. 首都医科大学学报, 2004, 25(1): 106-109.

Zhou Jianxin;Liu Jin. Dynamic Changes in Blood/Gas Partition Coefficient of Volatile Anesthetics during Cardiopulmonary Bypass[J]. Journal of Capital Medical University, 2004, 25(1): 106-109.

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