刘树春,刘兴敏
LIU Shuchun1,LIU Xingmin2 (1.Department of Anesthesiology

• 1:贵州省人民医院麻醉科
• 2:贵阳医学院附院
• 3:贵阳医学院附院麻醉科

摘要(Abstract)：

目的:研究吸入不同浓度七氟烷对中青年女性患者压力反射敏感性(BRS)的影响。方法:将择期行腰椎、腰椎间盘或下肢骨科手术的女性患者24例随机分成4组(n=6),对照组、0.7最低肺泡有效浓度(MAC)组、1.0MAC组及1.3MAC组;分别于麻醉诱导前和达到预定MAC平稳后测定4组患者的心率(HR)、收缩压(SBP)、平均动脉压(MAP)及基础代谢率(BRS)。结果:1.0MAC组与对照组及0.7MAC组相比,SBP、MAP明显降低(P<0.05),BRS明显降低,P<0.01;与对照组、0.7MAC组、1.0MAC组相比,1.3MAC组的SBP、MAP明显降低(P<0.05),BRS明显降低(P<0.01)。结论:1.0MAC与1.3MAC七氟烷抑制SBP及MAP,七氟烷引起的心率变化与BRS受抑制有关。
Objective:To study the effects of different concentrations of sevoflurane by inhaling on baroreflex sensitivity(BRS) of female patients.Methods:Twenty-four female patients accepting operation on lumbar spine,lumbar intervertebral disc or bones of lower limbs were randomly divided into 4 groups(n=6):control group,0.7MAC group,1MAC group and 1.3MAC group according to the end expiration concentrations of sevoflurane using MAC as unit.HR,SBP,MAP and BRS were detected before anesthesia induction and after reaching of a stable scheduled MAC status in sevoflurane groups.Results:SBP and MAP in 1MAC group were significantly lower than those in control group and 0.7MAC group(P<0.05);SBP and MAP in 1.3MAC group were significantly lower than those in control group,0.7MAC and 1MAC groups(P<0.05);BRS in 1MAC group were significantly lower than those in control group and 0.7MAC group(P<0.01);BRS in 1.3MAC group was significantly lower than those in control group,0.7MAC group and 1MAC group(P<0.05).Conclusions:1.3MAC and 1MAC sevoflurane could depress SBP and MAP.The change of HR caused by sevoflurane may relate to inhibition of BRS.

关键词(KeyWords)： 七氟烷;压力反射敏感性;麻醉,吸入
sevoflurane;baroreflex sensitivity;anesthesia,inhalation

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘树春,刘兴敏
LIU Shuchun1,LIU Xingmin2 (1.Department of Anesthesiology

DOI: 10.19367/j.cnki.1000-2707.2011.03.015

参考文献(References)：

• [1]庄心良,曾因明,陈伯銮.现代麻醉学[M].3版.北京:人民卫生出版社,2003:446-448.
• [2]Eger EIⅡ.New inhalational agents:desflurane andsevoflurane[J].Can J Anaesth,1993(5):3-8.
• [3]Bernard JM,Wouters PF,Doursout MF,et al.Effects ofsevoflurane and isoflurane on cardiac and coronary dy-namics in chronically instrumented dogs[J].Anesthesi-ology,1990(4):659.
• [4]王力群,郭继鸿.压力感受器敏感性试验[J].心电学杂志,2002(1):31-53.
• [5]马宇,熊原长,包睿,等.低流量吸入地氟醚或异氟醚控制性降压对患儿压力反射敏感性的影响[J].中华麻醉学杂志,2007(2):133-135.
• [6]Harkin CP,Pagel PS,Kersten JR,et al.Direct negative in-otropic and lusitropic effects of sevoflurane[J].Anesthe-siology,1994(1):156-167.
• [7]Lowe D,Hettrick DA,Pagel PS.Influence of volatile anes-thetics on left ventricular afterload in vivo:differencesbetween desflurane and sevoflurane[J].Anesthesiology,1996(1):112-120.
• [8]Miller R.D.米勒麻醉学[M].曾因明,邓小明,黄宇光,等,译.6版.北京:北京大学医学出版社,2006:200-204.
• [9]张萍.自主神经对心脏节律的调控[J].心电学杂志,2003(1):57-61.
• [10]马宇,邓小明,朱科明,等.脊柱矫形术患者控制性降压时异氟烷对压力反射敏感性的影响[J].中华麻醉学杂志,2005(8):569-571.
• [11]Tanaka M,Nishikawa T.Sevoflurane speeds recovery ofbaroreflex control of heart rate after minor surgical proce-dures compared with isoflurane[J].Anesth Analg,1999(2):284-289.

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