非体外循环冠状动脉旁路移植术中心肌缺血及麻醉研究

Off-pump Coronary Artery Bypass Grafting in Myocardial Ischemia and Anesthesia Research

目的:探讨麻醉方案对非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCABG)中心肌缺血的影响。方法:66例OPCABG患者给予中剂量芬太尼静脉注射,间断给予低浓度复合异氟醚,维库溴铵、丙泊酚、咪唑安定等。术中持续静脉点滴硝酸甘油;苯肾上腺素、多巴胺、肾上腺素等血管活性药,以维持稳定的血流动力学,并给予严密的监测。结果:66例患者均顺利完成手术,麻醉诱导前后及术中血流动力学平稳,无死亡病例。结论:选用合适的麻醉药物,并在术中给予严密的监测,可有效控制心肌缺血,对于OPCABG手术的成功来说,是非常必要的。

Objective：To explore the effect of anesthesia program on myocardial ischemia in off-pump coronary artery bypass grafting （OPCAB）.Methods：66 cases of OPCAB patients were given intravenous fentany, continuous inhalation low concentration compounded isoflurane,veeuronium,propofol,midazolam.During the surgery, for the stability of hemodynamics,it was given continuous I.V.drip of nitroglycerin;dopamine, norepinephrine and so on,and the strict monitoring were given,too.Results：66 cases of patients complicated the operation smoothly,before and after the induction of anesthesia and surgery, hemodynamies was steady. Conclusions：Choosing proper anesthesia drugs and giving strict monitoring during the surgery, can control myocardial ischemia effectively, and it was necessary for the success of OPCAB.