低流量异氟醚麻醉在胸科肿瘤手术中的应用(附43例报告)

Isoflurane Inhalation Anesthesia in Chest Surgery for Cancer.Report on 43 Cases

本文初步报告了采用环路外低流量循环紧闭吸入异氟醚麻醉在43例胸部肿瘤手术应用中,对呼吸及心血管系统的影响。结果发现异氟醚对呼吸有抑制作用。开胸后30分钟与术前相比,呼吸率由20.0±1.7次/分增加至23.0±2.5次/分,(P<0.01);潮气量由302±88ml至111±47ml(P<0.01);PCO_2由32.6±4.5mmHg升至44.2±10.5mmHg,(P<0.01)。心率在开胸后30分钟加快20％(P<0.01),但收缩压及舒张压均保持稳定。虽异氟醚对呼吸及心率确有一定影响,但麻醉效果仍佳,手术进行顺利,提示该法在胸部肿瘤手术中是一种较为理想的麻醉方法。

The respiratory and cardiovascular effects of isoflurane,a new inhalation anesthetic, were observed in 43 patients operated on for intra-thoracic cancer. Isoflurane was found to have inhibitive effects on the respiratory sys- tem. Comparisons were made between respiratory parameters prior to and 30 min. after the start of thoracotomy. Respira- tory rates showed an increase from 20.0±1. 7/min to 23. 0±2. 5/min (P<0. 01). VT values dropped from 302± 88ml to 111±47ml(P<0. 01). PCO_2 values increased from 32.6±14.5mmHg to 44.2±10. 5mmHg(P<0. 01 ). Thir- ty minutes after the chest being entered the mean heart rate increased by 20% (P<0. 01). Systolic and diastolic pressure values, however, remained unchanged. Although changes in respiratory and cardiovascular parameters were noted. the da- ta of anesthetic efficiency demonstrated that these changes had no clinical consequences and that isoflurane may be a sat- isfactory anesthetic in surgery of thoracic cancer, especially in patients with respiratory and cardiovascular dysfunctions.