23例冠状动脉搭桥术同时行心脏瓣膜置换术的麻醉处理

Anesthetic Management for 23 Patients Undergoing Coronary Artery Bypass Grafting Combined with Valve Replacement

本文总结23例冠状动脉搭桥术同时行心脏瓣膜置换术的麻醉。20例术前有ST-T改变。选用对循环影响轻的麻醉方式。用大剂量芬太尼麻醉，复合异丙酚，氨氟醚维持，效果良好。术中应用硝酸甘油，硝普钠降低前后负荷。体外循环后7例低心排病人用多巴肢和10例心动过缓病人用异丙肾上腺素治疗，效果显著。

The experience of anesthetic management for 23 patients undergoing coronary artery bypass grafting (CABG) Combined with valve replacement are summarized in this paper. Twenty of the patients had ST-T abnormalities preoperatively. Anesthesia was maintained with high - dose fentanyl and supplemented with propofol and enflurane. An intravenous infusion of nitroglycerin and sodium nitroprusside was given for decreasing preload and afterload during the Operation. After cardiopulmonary bypass (CPB): dopamine was infused for correction Of low cardiac output in 7 patients with good results. In 10 Patients isoprenaline was used for correcting the bradycardia after CPB.