中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2014年
12期
1449-1451
,共3页
孙震%胡玉莹%吕晶%郑晓恬
孫震%鬍玉瑩%呂晶%鄭曉恬
손진%호옥형%려정%정효념
麻醉药,吸入%儿童%脑血管循环
痳醉藥,吸入%兒童%腦血管循環
마취약,흡입%인동%뇌혈관순배
Anesthetics,inhalation%Child%Cerebrovascular circulation
目的 评价不同七氟醚麻醉深度对幼儿脑血管自动调节功能的影响.方法 择期尿道下裂成形术患儿20例,ASA分级Ⅰ级,年龄1～3岁.吸入6％七氟醚麻醉诱导后插入喉罩,进行机械通气.插入喉罩后行骶管阻滞.吸入七氟醚维持麻醉,调节呼气末七氟醚浓度,分别为1.8％、2.5％、3.3％和4.0％,每一个浓度均维持15 rmin,并在调节下一个浓度前即刻采集大脑中动脉的脑血流多普勒频谱,测定脑短暂充血反应率(THRR).结果 七氟醚不同麻醉深度时THRR均大于1.09,在正常范围;与呼气末七氟醚浓度为1.8％时比较,2.5％、3.3％和4.0％时THRR降低(P＜0.05),2.5％与3.3％时THRR比较无差异无统计学意义(P＞0.05);与2.5％和3.3％时比较,4.0％时THRR降低(P＜0.05).结论 虽然七氟醚麻醉对幼儿脑血管自动调节功能的抑制作用无明显临床意义,但是具有显著性意义.
目的 評價不同七氟醚痳醉深度對幼兒腦血管自動調節功能的影響.方法 擇期尿道下裂成形術患兒20例,ASA分級Ⅰ級,年齡1～3歲.吸入6％七氟醚痳醉誘導後插入喉罩,進行機械通氣.插入喉罩後行骶管阻滯.吸入七氟醚維持痳醉,調節呼氣末七氟醚濃度,分彆為1.8％、2.5％、3.3％和4.0％,每一箇濃度均維持15 rmin,併在調節下一箇濃度前即刻採集大腦中動脈的腦血流多普勒頻譜,測定腦短暫充血反應率(THRR).結果 七氟醚不同痳醉深度時THRR均大于1.09,在正常範圍;與呼氣末七氟醚濃度為1.8％時比較,2.5％、3.3％和4.0％時THRR降低(P＜0.05),2.5％與3.3％時THRR比較無差異無統計學意義(P＞0.05);與2.5％和3.3％時比較,4.0％時THRR降低(P＜0.05).結論 雖然七氟醚痳醉對幼兒腦血管自動調節功能的抑製作用無明顯臨床意義,但是具有顯著性意義.
목적 평개불동칠불미마취심도대유인뇌혈관자동조절공능적영향.방법 택기뇨도하렬성형술환인20례,ASA분급Ⅰ급,년령1～3세.흡입6％칠불미마취유도후삽입후조,진행궤계통기.삽입후조후행저관조체.흡입칠불미유지마취,조절호기말칠불미농도,분별위1.8％、2.5％、3.3％화4.0％,매일개농도균유지15 rmin,병재조절하일개농도전즉각채집대뇌중동맥적뇌혈류다보륵빈보,측정뇌단잠충혈반응솔(THRR).결과 칠불미불동마취심도시THRR균대우1.09,재정상범위;여호기말칠불미농도위1.8％시비교,2.5％、3.3％화4.0％시THRR강저(P＜0.05),2.5％여3.3％시THRR비교무차이무통계학의의(P＞0.05);여2.5％화3.3％시비교,4.0％시THRR강저(P＜0.05).결론 수연칠불미마취대유인뇌혈관자동조절공능적억제작용무명현림상의의,단시구유현저성의의.
Objective To evaluate the effects of different depths of anesthesia with sevoflurane on cerebrovascular autoregulation in infants.Methods Twenty pediatric patients,of ASA physical status Ⅰ,aged 1-3 yr,undergoing elective hypospadias plasty surgery,were enrolled in the study.Single tube laryngeal mask was inserted after anesthesia was induced with 6％ sevoflurane inhalation.Caudal block was performed with 1 ml/kg of 0.2％ ropivacaine.Anesthesia was maintained with sevoflurane inhalation.The end-tidal sevoflurane concentration was adjusted to 1.8％,2.5％,3.3％ and 4.0％,and each concentration was maintained at this level for 15 min.The cerebral blood flow was collected from the middle cerebral artery immediately before adjusting the next concentration to record the Doppler spectrum and transient hyperemic response ratio (THRR) was measured.Results THRR at different depths of anesthesia with sevoflurane was larger than 1.09,and was within the normal range.THRR was significantly lower when the end-tidal concentration was 2.5％,3.3％ and 4.0％ than that obtained when end-tidal concentration was 1.8％.No significantdifference was detected in THRR between 2.5％ and 3.3 ％.THRR was significantly lower when the end-tidal concentration was 4.0 ％ than that obtained when the end-tidal concentration was 2.5％ and 3.3％.Conclusion Although the inhibitory effect on cerebrovascular autoregulation provided by sevoflurane anesthesia provides no obvious clinical significance,it shows statistical significance in infants.
