[使用脑电图辅助测定麻醉剂量时的摄氧量和血液循环参数]。

D Hausmann, H Schwilden, J Nadstawek, W Krajewski
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引用次数: 0

摘要

麻醉对循环和氧化代谢有显著影响,两者密切相关。通常摄氧量(VO2)和能量消耗明显减少。由于缺乏对标准化条件下患者的研究,关于所施用药物的影响和代谢性抑郁程度的争议性讨论在文献中继续存在。采用定量脑电图分析方法,对18例拟行腹部大手术患者(ASA I-II)进行闭环反馈控制麻醉。组1采用甲氧己酮加芬太尼全静脉麻醉,组2采用阿芬太尼加N2O联合麻醉。本比较研究的目的是评估不同全麻技术对吸氧和心血管系统的影响。氟硝西泮预用药后的麻醉前VO2值略低于间接量热法测定的基础代谢预测范围。稳态全身麻醉导致两组VO2减少约30%。与摄氧量相比,血压,特别是心率是由麻醉类型定义的,在甲氧己美芬太尼组中,血压和心率都观察到较高的值。
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[Oxygen uptake and blood circulation parameters during anesthesia using EEG-assisted determination of anesthetic dosages].

Anaesthesia has significant effects on circulation and oxidative metabolism which are closely related to each other. Usually there is a marked reduction of oxygen uptake (VO2) and energy expenditure. A controversial discussion on the effects of the drugs administered and the degree of metabolic depression has continued in the literature fuelled by a lack of studies in patients under standardized conditions. 18 patients (ASA I-II) scheduled for major abdominal surgery were given closed-loop feedback control anaesthesia by quantitative EEG analysis. Group 1 received a total intravenous anaesthesia with methohexital and fentanyl whereas group 2 was given a combined anaesthesia with alfentanil and N2O. The aim of this comparative study was to evaluate the effects of different techniques for general anaesthesia on oxygen uptake and on the cardiovascular system. Preanaesthetic values of VO2 taken after flunitrazepam premedication were slightly below the predicted range determined by indirect calorimetry for basal metabolism. Steady-state general anaesthesia led to an approximately 30% reduction of VO2 for both groups. In contrast to oxygen uptake, blood pressure and especially heart rate were defined by the type of anaesthesia as in the methohexital fentanyl group higher values of both blood pressure and heart rate were observed.

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