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Medicine:通过压力记录分析法评估七氟醚和氯胺酮对小儿室间隔缺损患者诱导期血流动力学影响的比较

2018-02-06 李华宇 “罂粟花”微信号

七氟醚和氯胺酮是小儿心脏手术不合作患者镇静及静脉麻醉诱导常用的药物。我们采用一种新的、直接的全身血流动力学监测技术——压力记录分析法,比较七氟醚和氯胺酮对静脉麻醉诱导期患者血流动力学的影响。

背景与目的:七氟醚和氯胺酮是小儿心脏手术不合作患者镇静及静脉麻醉诱导常用的药物。我们采用一种新的、直接的全身血流动力学监测技术——压力记录分析法,比较七氟醚和氯胺酮对静脉麻醉诱导期患者血流动力学的影响。

方  法:纳入44例室间隔缺损患儿(2.2±1.2岁),随机分为吸入七氟醚(S组)或肌注氯胺酮(k组)用于镇静,然后静脉注射咪达唑仑-舒芬太尼诱导后行气管插管。记录的参数包括心率(HR)、动脉压、心搏指数(SVI)、心脏指数(CI)、全身血管阻力指数(SVRI)和七氟醚或氯胺酮镇静后、咪达唑仑-舒芬太尼注射后1、2、5分钟及气管插管后1、2、5、10分钟时收缩压上升最大斜率(dp/dtmax)。计算出心率血压乘积(RPP)和心功率输出(CPO)。

结  果:在整个研究期间,与S组相比,K组静脉麻醉诱导期间动脉压快速降低(P<0.01),且具有较高的心率、动脉压、SVRI、dp/dtmax、RPP及较低的SVI、CI、CPO(P<0.05)。

结  论:与七氟醚相比,氯胺酮对小儿室间隔缺损患者静脉麻醉诱导期间的全身血流动力学和心肌能量存在负面影响。

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    2018-08-08 jeanqiuqiu
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2018, time=2018-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577590, encodeId=167415e7590a0, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Thu Feb 08 04:35:00 CST 2018, time=2018-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608537, encodeId=dd7d160853e42, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Feb 08 04:35:00 CST 2018, time=2018-02-08, status=1, ipAttribution=)]
    2019-01-15 kalseyzl
  5. 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2018, time=2018-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577590, encodeId=167415e7590a0, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Thu Feb 08 04:35:00 CST 2018, time=2018-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608537, encodeId=dd7d160853e42, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Feb 08 04:35:00 CST 2018, time=2018-02-08, status=1, ipAttribution=)]
    2018-02-08 jml2009
  6. 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  7. 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相关资讯

Eur J Anaesthesiol:小儿七氟醚麻醉苏醒期的临床行为特征和脑电图类型:一项观察研究

很少有研究系统地描述了小儿麻醉苏醒期的临床行为体征、脑电图(EEG)类型和年龄之间的关系。

Mol Med Rep:新生小鼠反复吸入七氟醚抑制浦肯野细胞的信息传递并且通过GABAA受体的ε(艾普西龙)亚基减缓运动神经发育

尽管全身麻醉对小脑信息传递和运动功能的影响尚不清楚,但是全身麻醉还是广泛应用于小儿外科手术。

PLoS One:七氟醚显著延长高血糖患者的QTc间期

QTc间期延长是糖尿病患者的一种严重并发症并增加其死亡率。高血糖抑制延迟整流钾通道电流的快速成分(Ikr)而引起心电图QTc间期的延长。同时七氟醚抑制Ikr 引起QTc间期延长。事实上,尖端扭转型室速也发生在七氟醚麻醉期间糖尿病控制不佳的患者身上。

Anesth Analg:较之异氟醚,七氟醚可很大程度减轻大鼠肺源性急性呼吸窘迫综合征引起的肺损伤

挥发性麻醉药能调节急性呼吸窘迫综合征(ARDS)中的炎症反应。而它们是否因为ARDS病因的不同而呈现出不同作用,目前尚不十分清楚。我们假设体内、体外实验中,七氟醚和异氟醚在肺源性(p)和非肺源性(exp)ARDS对肺损伤的影响中不存在差异。

Anaesthesist:2%七氟烷反复吸入会导致青年大鼠神经毒性和认知功能障碍

七氟醚是儿科麻醉中使用最广泛的吸入麻醉药之一。大量研究表明,在新生儿期七氟醚高浓度麻醉或持续时间较长的反复治疗可诱发神经细胞凋亡和长期学习障碍。在临床实践中,我们观察到一部分患者在七氟醚麻醉下从出生到青春期不止一次进行了小手术。因此,本研究旨在探讨七氟醚浓度为2%(七氟烷临床相关用量)持续1 h(持续时间短)在新生儿期是否可诱导接受七氟醚(2%,1 h)的青春期大鼠神经细胞凋亡和神经认知功能障碍。

Life Sci:反复接触七氟醚会损害老年雄性大鼠的学习能力和记忆

危重病患者常需要反复手术干预,因此探讨反复接触麻醉药物对学习和记忆的影响就显得非常重要。七氟醚是一种广泛使用的吸入麻醉剂,对神经系统几乎没有副作用,并能使意识迅速恢复。但七氟醚暴露的长期影响和重复七氟醚暴露后对认知功能的影响却少有文献报道,这与现有的研究相矛盾。

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