不同剂量丙泊酚对老年患者心血管功能的影响

Effects of different doses of propofol on cardiovascular responses in aged patients

目的 监测丙泊酚用于老年患者全麻诱导期间对心脏功能的影响。方法 ASAⅠ～Ⅱ级拟行腹部手术的老年患者 30例 ,随机分成三组 ,经鼻放置食管超声多普勒探头。分别静注丙泊酚 1 0mg/kg(Ⅰ组 )、1 5mg/kg(Ⅱ组 )和 2 0mg/kg(Ⅲ组 )。观察MAP、HR、心输出量 (CO)、每搏量 (SV)、全身血管阻力 (TSVR)、血流加速度 (Acc)、峰流速 (PV)、左心室射血时间指数 (LVETI)值。结果 Ⅲ组在注药后 5、10min时HR、CO、SV、TSVR、Acc、PV、LVETI值与麻醉前比差异均有极显著性 (P <0 0 1)。结论 2 0mg/kg丙泊酚诱导抑制老年人心肌收缩功能。丙泊酚用于老年患者全麻诱导时的剂量宜为 1 0～ 1 5mg/kg。

Objective To investigate the effects of different doses of propofol on cardiac function in aged patients.Methods Thirty ASA Ⅰ-Ⅱ aged patients(65-70 years)were randomly divided into three groups.In group Ⅰ(n=10),propofol 1.0 mg/kg was administered for anesthetic induction,in group Ⅱ(n=10),propofol 1.5 mg/kg,and in group Ⅲ(n=10) propofol 2.0 mg/kg respectively.Mean arterial pressure(MAP),heart rate(HR),cardiac output(CO),stroke volume(SV),blood flow acceleration(Acc),peak velocity(PV),total systemic vascular resistance(TSVR),and left ventricular ejection time index(LVETI)were determined with transesophageal Doppler monitor.All hemodynamic data were recorded before injection,at 1,5,10 min after injection.Results In group Ⅲ,MAP,CO,SV,Acc,TSVR and PV fell dramatically(P<0.05 and P<0.01)at 10 and 15 min after injection.LVETI also was lengthened significantly at the same time points.Conclusion Propofol 2.0 mg/kg inhibits myocardial contractile function.Propofol 1.0-1.5 mg/kg may be administrated safely during induction in aged patients.