氧化亚氮对血乳酸的影响

The effect of nitrous oxide to the blood lactate.

２１冽非经胸手术患者，随机分为实验组１１例，Ｎ２Ｏ－普鲁卡因复合全麻）和对照组（１０例，普鲁卡因复合全麻），观察除外缺氧。低血压休克等因素后 Ｎ２Ｏ对血乳酸的影响。结果提示，吸入 ５０％～６０％Ｎ２Ｏ １小时后动脉血乳酸值（２．４７±０．６１ｍｍｏｌ／Ｌ）较麻醉诱导前（１．４９±０．４０ｍｍｏｌ／Ｌ）明显增加（Ｐ＜０．０１）；而对照组血乳酸无明显变化（从１．０３±０．３２ｍｍｏｌ／Ｌ．增至１．５９±０．５７ｍｍｏｌ／Ｌ，Ｐ＞０．０５）。此结果说明，５０％～６０％Ｎ２Ｏ可导致血浆乳酸浓度增加，虽所增加数值较微，未见明显临床意义，但对于危重．应激叵应强烈以及代谢功能紊乱等患者的影响，有待进一步探讨。

Fffect of nitrous oxide (N2O) to the blood lactate was investigated,21 healthy adult cases undergoing non-cardio thoracic surgery were observed Group 1 (n=11) received N2O combined with intravenous procaine general anaesthesia;Group 2 (n=10) received in- travenous procaine general anaesthesia without N2O as control.The concentrations of arterial blood lactate were assayed before induction, an hour after induction and the termination of the operation.In group 1, the blood lactate was increased from 1.49+0.40mmol/L before induction to 2.47+0.61 mmol/L an hour after the inhalation of 50%~60% N2O (P<0.01 )and it was not significantly changed in group 2 (1.03+0.32 mmol/L^1.59+0.57mmol/L,P>O.05). The study indicates that the blood lactate increased slightly during 50%-60 % N2O anaesthesia but the effects of N2O to the blood lactate in patients with crimical,stressed and metabolic disturbed conditions need further inves tigation