我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

七氟醚对插管应激时心率变异性的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第4期
页码:
280-284
栏目:
论著
出版日期:
2000-08-01

文章信息/Info

Title:
Effects of sevoflurane on heart rate variability during stress responses to tracheal intubation
作者:
侯立朝1;  张宏2;  熊利泽1
1. 第四军医大学西京医院麻醉科, 陕西西安710032; 2. 解放军总医院麻醉科
Author(s):
HOU Li-chao1;  ZHANG Hong2;  XIONG Li-ze1
1.Department of Anesthesiology, Xijing Hospital, Xi′an Shaanxi 710032, China; 2.Department of Anesthesioligy, General Hospital of PLA, Beijing
关键词:
七氟醚; 插管应激反应; 心率变异性
Keywords:
sevoflurane; stress responses; tracheal intubation; heart rate variability
分类号:
R954
DOI:
-
文献标识码:
A
摘要:
目的 观察不同浓度的七氟醚对插管应激时心率变异性的影响。方法 ASA I～II级外科择期手术患者23例，随机分为A,B两组。面罩吸入1.0vol%（A组）或3.0vol% （B组）七氟醚和N2O∶O2(2∶1)混和气进行麻醉诱导；气管内插管行机械通气。持续监测血流动力学指标，记录心电图并进行心率变异功率频谱分析（HRV-PSA）；抽取静脉血测定PcAMP及PcGMP。结果 插管后，所有患者的血压、心率、HRV-PSA有关参数值及PcAMP和PcGMP均有所增加（P＜0.05），以A组（1.0vol%七氟醚）患者的反应较显著（P＜0.05）。结论 七氟醚用于麻醉诱导可有效地降低低插管所致的循环反应和自主神经反应，从而为临床麻醉管理提供依据。
Abstract:
AIM To observe the effects of sevoflurane on the stress responses and heart rate variability to endotracheal intubation. METHODS Twenty-three patients with physical status Grade I～II of American society of anesthesiologists, scheduled for elective surgical operations, were randomly divided into two groups: low-concentration （1.0vol%）group ( Group A: n=11 ) and high-concentration （3.0vol%）group ( Group B: n=12 ). Anesthesia was induced with a mixture of sevoflurane in N2O-O2 (N2O∶O2 =2∶1 ). After endotracheal intubation, the patients were continuously maintained by mechanical ventilation. Hemodynamics was monitored. Electrocardiograph was continuously recorded for power spectral analysis of heart rate variability (HRV-PSA). And blood samples for PcAMP,PcGMP were taken. RESULTS The increases of blood pressure, heart rate, PcAMP and PcGMP, the total HRV and the frequency components of HRV power spectrum as well as MF/HF ratio after tracheal intubation were more in Group A than those in Group B. CONCLUSIONs Sevoflurane could effectively reduce the circulatory and autonomous nerve responses to endotracheal intubation, which would benefit the management of clinical anesthesia.

参考文献/References

[1] Cohen H, Matar MA, Kaplan Z, et al. Power spectral analysis of heart rate variability in psychiatry［J］. Psychother Psychosom, 1999, 68(2):59.

［2］ Laitinen T, Vauhkonen IK, Niskanen LK, et al. Power spectral analysis of heart rate variability during hyperinsulinemia in nondiabetic offspring of type 2 diabetic patients: evidence for possible early autonomic dysfunction in insulin-resistant subjects［J］. Diabetes, 1999, 48(6):1295.

［3］ McLeod KA, Hillis WS, Houston AB, et al. Reduced heart rate variability following repair of tetralogy of Fallot［J］. Heart, 1999, 81(6):656.

［4］ Mangano DT. Perioperative cardiac morbidity［J］. Anesthesiology, 1990, 72: 153.

［5］ 徐建设，史誉吾. 　麻醉、手术和应激反应［J］. 国外医学（麻醉学与复苏分册），1994, 15(3): 129.

［6］ Latson T, McCarroll S, Mirhej M, et al. Effects of three anesthetic induction techniques on heart rate variability［J］. J Clin Anesth, 1992, 4: 265.

［7］ Licker M, Farinelli C, Klopfenstein CE. Cardiovascular reflexes during anesthesia induction and tracheal intubation in elderly patients: the influence of thoracic epidural anesthesia［J］. J Clin Anesth, 1995, 7(6): 281.

［8］ Viitanen H, Annila P, Viitanen M, et al. Premedication with midazolam delays recovery after ambulatory sevoflurane anesthesia in children［J］. Anesth Analg, 1999, 89(1):75.

［9］ Pagel SS, Goa KL. Sevoflurane: a review of its pharmacodynamic and pharmacokinetic properties and its clinical use in general anesthesia［J］. Drug, 1996, 51(4): 658.

　［10］Sarner JB, Levine M, Davis PJ, et al. Clinical characteristics of sevoflurane in children: a comparison with halothane［J］. Anesthesiology, 1995, 82(1): 38.

［11］Lien C, Belmont M, Hemmings H, et al. Efficacy of sevoflurane versus propofol for the induction and maintenance of anesthesia (abstract) ［J］. Anesth Analg, 1995, 80(2S)Suppl: S282.

［12］Yurino M, Kimura H. Comparison of induction time and characteristics between sevoflurane and sevoflurane-nitrous oxide［J］. Acta Anaesthesiol Scand, 1995, 39: 356.

［13］Sivalingam P, Kandasamy R, Madhavan G, et al. Conditions for laryngeal mask insertion. A comparison of propofol versus sevoflurane with or without alfentanil［J］. Anaesthesia, 1999, 54(3):271.

［14］Lowry DW, Carroll MT, Mirakhur RK, et al. Comparison of sevoflurane and propofol with rocuronium for modified rapid-sequence induction of anaesthesia［J］. Anaesthesia, 1999, 54(3):247.

备注/Memo

备注/Memo:
收稿日期：1999-07-13.
更新日期/Last Update: 2000-08-01