异丙酚复合芬太尼静脉全麻时能量代谢的变化

The effects of propofol combined with fentanyl on metabolic rate of energy expenditure during anesthesia

目的:探讨异丙酚复合芬太尼静脉全麻对能量代谢的影响。方法:选择31例成年ASA Ⅰ～Ⅱ级择期手术的神经外科患者,行异丙酚复合芬太尼静脉全麻,测定麻醉期的氧耗量(VO_2)、二氧化碳产量(VCO_2)、呼吸商(RQ)和能量代谢率(MR)。结果:体位变动和强手术刺激时VO_2和MR升高。无手术刺激时的VO_2和MR分别为麻醉前的91.09%、91.29%(P<0.05),为手术时的93.58%、94.93%(P<0.05)。RQ随时间延长逐渐从麻醉前的0.95±0.29降至0.79±0.09。麻醉手术状态下VCO_2变化趋势平稳。结论:(1)异丙酚-芬太尼静脉麻醉下颅脑手术的VO_2和MR与手术刺激强度显示相关性;(2)RQ随麻醉时间延长有逐渐降低倾向。

To observe the effects pf propofol combined with fentanyl on metabolic rate of energy cxpen diture in anesthesia. Method: Thirty-one elective neurosurgical adult patients, ASA class Ⅰ-Ⅱ, received tolal intravenous anesthesia with propofol combined with fentanyh Oxygen consumption (VO_2), carbon dioxide production (VCO_2), respiratory quotient(RQ), metabolic rate(MR)were measured. Resuh: VO_2 and MR increased when patients' posture changed or there existed strong operative stimulation. VO_2 and MR during post induction were 91.09% and 91.29% of the level before anesthesia respectively(P<0.05),and wcre 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 post induction and operation. Conclusion: (1)Change of VO_2 and MR are related to the degree of operative stimulation in neurosurgical patients with propofol-fentanyl anesthesia. (2) RQ trend showes gradually decreasing during anesthesia.