氟烷和氯胺酮麻醉下脑静脉血氧分压和氧含量的变化

Changes of Cerebral Blood PvO 2 and CvO 2 during Halothane or Ketamine Anesthesia in Man

本研究选择ＡＳＡⅠ～Ⅱ级，行腹部手术的成年病人２５例，随机分为氟烷组（１４例）和氯胺酮组（１１例），分别于麻醉前、麻醉后３０ｍｉｎ和６０ｍｉｎ，同时采取动脉血和颈内静脉血进行血气分析。结果：两组间动脉氧分压和氧含量无显著差异（Ｐ＞０．０５）；两组间颈内静脉血氧分压和氧含量在麻醉前差异不显著，在麻醉后差异显著（Ｐ＜０．０５）或十分显著（Ｐ＜０．０１）。说明氟烷可使脑耗氧量降低，而氯胺酮则否。

25 adult patients(ASAⅠ～Ⅱ) scheduled for abdominal operation were divided into two groups:halothane anesthesia group (n=14) and ketamine anesthesia group (n=11). Halothane 0 8～1 8MAC in halation or ketamine 3mg·kg -1 /h intravenously were administered respectively. The blood samples of the artery and the internal jugular vein were taken before anesthesia, at 30min and 60min after anesthesia. PaO 2、CaO 2 and PvO 2、CvO 2 were measured. Results show that PaO 2 and CaO 2 of two groups were roughly the same. There was a significant difference in PvO 2 and CvO 2 between two groups at 30min (P<0 05) and 60min (P<0 01) after anesthesia. The findings suggest that halothane can increase cevebral PvO 2 and CvO 2, while ketamine not. It may be resulted from different effects of halothane and ketamine on cerebral blood flow and metabolic rate.