咪唑安定芬太尼复合全麻对能量代谢的影响

Effects of Midazolam Combined with Fentanyl on Energy Metabolism During General Anesthesia

目的 探讨咪唑安定芬太尼复合全麻时能量代谢的变化。方法 选择 35例成年择期手术的神经外科患者 ,ASAⅠ～Ⅱ级 ,行咪唑安定复合芬太尼静脉全麻 ,测定麻醉期的氧耗量 (VO2 )、二氧化碳产量(VCO2 )、呼吸商 (RQ)和能量代谢率 (MR)。结果 体位变动和强手术刺激时VO2 和MR升高。无手术刺激时的VO2 和MR分别为麻醉前的 91.0 9%、91.2 9% (P <0 .0 5) ,手术时为手术前的 93.58%、94 .93% (P <0 .0 5)。RQ随时间延长逐渐从麻醉前的 0 .95± 0 .2 9降至 0 .79± 0 .0 9。麻醉手术状态下VCO2 变化趋势平稳。结论 ( 1)咪唑安定、芬太尼及静脉全麻下颅脑手术的VO2 和MR与手术刺激强度显示相关性 ;( 2 )

Objective To observe the effects of Midazolam combined with Fentanyl on energy motabolism in general anesthesia.Methods 35 selected neurosurgical adult patients,ASA class Ⅰ-Ⅱ,received total intravenous general anesthesia with Midazolam combined with Fentanyl.Oxygen consumption( VO 2 ) ,carbon dioxide production(VCO 2),respiratory quotient(RQ),and metabolism rate(MR) were measured.Results VO 2 and MR increased when patients' posture changed or there existed strong operative stimulation.VO 2 and MR during postinduction were 91.09% and 91.29 % of the level before anesthesia respectively(P<0.05),and were 93.58% and 94.93% of that during operation respectively(P<0.05).As anesthesia duration lasted,RQ decreased gradually from 0.95±0.29(before anesthesia) to 0.79±0.09,VCO 2 showed a stable trend during both postinduction and operation.Conclusion (1) Change of VO 2 and MR are related to the degree of operative stimulation in neurosurgical patients with Midazolam-Fentanyl anesthesia.(2)RQ trend shows gradually decreasing during anesthesia.