中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2010年
3期
297-299
,共3页
柳娟%贾兴元%张晴%岳云
柳娟%賈興元%張晴%嶽雲
류연%가흥원%장청%악운
二异丙酚%氧%氧化性应激%七氟烷
二異丙酚%氧%氧化性應激%七氟烷
이이병분%양%양화성응격%칠불완
Propofol%Oxygen%Oxidative stress%Sevoflurane
目的 评价异丙酚和七氟烷对全麻病人短时间吸入纯氧诱发氧化应激反应的影响.方法 择期拟行开腹手术全麻病人60例,年龄20～60岁,体重50～85kg,ASAⅠ或Ⅱ级,随机分为4组(n=15),各组均依次静脉注射舒芬太尼0.1～0.2 mg/kg、咪达唑仑0.02 mg/kg、异丙酚1～2 mg/kg和罗库溴铵0.6～0.8 mg/kg麻醉诱导,气管插管后行机械通气.麻醉维持:Ⅰ组和Ⅱ组静脉输注异丙酚100～150μg·kg-1·min-1,FiO2分别为40%和100%,Ⅲ组和Ⅳ组吸入1.5%～3.0%七氟烷,FiO2分别为40%和100%,各组均静脉输注瑞芬太尼0.5～1.0μg·kg-1·min-1,间断静脉注射罗库溴铵0.15 mg/kg,维持BIS 40～60.于麻醉诱导前(基础状态)、气管插管后2、4、6h、术后24h时(T1-4)采集动脉血样,测定PaO2、血清8-异前列腺素F2α(8-iso-PGF2α)、MDA浓度和SOD活性,并计算PaO2/FiO2.结果 与基础值比较,T1-3时Ⅰ组、Ⅱ组和Ⅲ组PaO2/FiO2升高,Ⅳ组血清8-iso-PGF2α和MDA浓度升高,SOD活性降低(P<0.05或0.01).与Ⅱ组和Ⅲ组比较,Ⅳ组T1～3时PaO2/FiO2降低,血清8-iso-PGF2α和MDA浓度升高,SOD活性降低(P<0.05).Ⅰ组与Ⅱ组间上述指标比较差异无统计学意义(P>0.05).结论 静脉输注异丙酚100～150μg·kg-1·min-1维持麻醉可抑制全麻病人短时间(≤6 h)吸人纯氧诱发氧化应激反应,而吸入1.5%～3.0%七氟烷维持麻醉则不能.
目的 評價異丙酚和七氟烷對全痳病人短時間吸入純氧誘髮氧化應激反應的影響.方法 擇期擬行開腹手術全痳病人60例,年齡20～60歲,體重50～85kg,ASAⅠ或Ⅱ級,隨機分為4組(n=15),各組均依次靜脈註射舒芬太尼0.1～0.2 mg/kg、咪達唑崙0.02 mg/kg、異丙酚1～2 mg/kg和囉庫溴銨0.6～0.8 mg/kg痳醉誘導,氣管插管後行機械通氣.痳醉維持:Ⅰ組和Ⅱ組靜脈輸註異丙酚100～150μg·kg-1·min-1,FiO2分彆為40%和100%,Ⅲ組和Ⅳ組吸入1.5%～3.0%七氟烷,FiO2分彆為40%和100%,各組均靜脈輸註瑞芬太尼0.5～1.0μg·kg-1·min-1,間斷靜脈註射囉庫溴銨0.15 mg/kg,維持BIS 40～60.于痳醉誘導前(基礎狀態)、氣管插管後2、4、6h、術後24h時(T1-4)採集動脈血樣,測定PaO2、血清8-異前列腺素F2α(8-iso-PGF2α)、MDA濃度和SOD活性,併計算PaO2/FiO2.結果 與基礎值比較,T1-3時Ⅰ組、Ⅱ組和Ⅲ組PaO2/FiO2升高,Ⅳ組血清8-iso-PGF2α和MDA濃度升高,SOD活性降低(P<0.05或0.01).與Ⅱ組和Ⅲ組比較,Ⅳ組T1～3時PaO2/FiO2降低,血清8-iso-PGF2α和MDA濃度升高,SOD活性降低(P<0.05).Ⅰ組與Ⅱ組間上述指標比較差異無統計學意義(P>0.05).結論 靜脈輸註異丙酚100～150μg·kg-1·min-1維持痳醉可抑製全痳病人短時間(≤6 h)吸人純氧誘髮氧化應激反應,而吸入1.5%～3.0%七氟烷維持痳醉則不能.
목적 평개이병분화칠불완대전마병인단시간흡입순양유발양화응격반응적영향.방법 택기의행개복수술전마병인60례,년령20～60세,체중50～85kg,ASAⅠ혹Ⅱ급,수궤분위4조(n=15),각조균의차정맥주사서분태니0.1～0.2 mg/kg、미체서륜0.02 mg/kg、이병분1～2 mg/kg화라고추안0.6～0.8 mg/kg마취유도,기관삽관후행궤계통기.마취유지:Ⅰ조화Ⅱ조정맥수주이병분100～150μg·kg-1·min-1,FiO2분별위40%화100%,Ⅲ조화Ⅳ조흡입1.5%～3.0%칠불완,FiO2분별위40%화100%,각조균정맥수주서분태니0.5～1.0μg·kg-1·min-1,간단정맥주사라고추안0.15 mg/kg,유지BIS 40～60.우마취유도전(기출상태)、기관삽관후2、4、6h、술후24h시(T1-4)채집동맥혈양,측정PaO2、혈청8-이전렬선소F2α(8-iso-PGF2α)、MDA농도화SOD활성,병계산PaO2/FiO2.결과 여기출치비교,T1-3시Ⅰ조、Ⅱ조화Ⅲ조PaO2/FiO2승고,Ⅳ조혈청8-iso-PGF2α화MDA농도승고,SOD활성강저(P<0.05혹0.01).여Ⅱ조화Ⅲ조비교,Ⅳ조T1～3시PaO2/FiO2강저,혈청8-iso-PGF2α화MDA농도승고,SOD활성강저(P<0.05).Ⅰ조여Ⅱ조간상술지표비교차이무통계학의의(P>0.05).결론 정맥수주이병분100～150μg·kg-1·min-1유지마취가억제전마병인단시간(≤6 h)흡인순양유발양화응격반응,이흡입1.5%～3.0%칠불완유지마취칙불능.
Objective To investigate the effects of propofol and sevoflurane on oxidative stess response induced by short period pure oxygen inhalation during general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-60 yr weighing 50-85 kg undergoing elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n=30 each):group propofol (group P) and group sevoflurane (group S).Each group was further divided into 2 subgroups inhaling 40% O2 (P0.4,S0.4) and 100%O2(P1.0,S1.0) respectively during operation.Anesthesia was induced with propofol 1-2 mg/kg,midazolan 0.02 mg/kg and sufentanil 0.1-0.2 mg/kg.Tracheal intobation was facilitated with rocuronium 0.6-0.8 mg/kg.The patients were mechanically ventilated(VT 8 ml/kg,RR 12 bpm).PET CO2 was maintained at 35-40 mmHg.Anesthesia was maintained with in both groups.BIS was maintained at 40-60.Arterial blood samples were collected immediately before induction of anesthesia (baseline),at 2,4,6h after tracheal intubation(T1-3) and 24h after operation(T4) for determination of PaO2,serum 8-iso-PGF2α and MDA concentrations and SOD activity.PaO2/FiO2 was calculated.Results In subgroup S1.0 the serum 8-iso-PGF2α and MDA concentrations were significantly increased while serum SOD activity was significanfly decreased at T1-3 as compared with the baseline.Serum 8-iso-PGF2α and MDA concentrations were significantly higher while serum SOD activity and PaO2/FiO2 were significantly lower at T1-3 in subgroup S1.0 than in stress response induced by≤6h pure O2 inhalation but inhalation of 1.5%-3.0% sevoflurane can not.
