异丙酚麻醉下PaCO_2对SjvO_2影响的年龄差异

Age related Influence of Propofol or Isoflurane on SjvO_2 Varied with PaCO_2 in Neurosurgical Patients

目的 :研究异氟醚和异丙酚维持神经外科手术中低碳酸和高碳酸血症对颈静脉球血氧饱和度 (SjvO2 )影响的年龄差异。方法 :2 0例以异丙酚 2mg/kg、芬太尼 2 μg/kg和阿曲库铵 0 5mg/kg诱导麻醉 ,维持麻醉异丙酚 6～10mg·kg-1·h-1。并选择 2 0例相似病人用硫喷妥钠诱导和异氟醚 1～ 1 3MAC维持麻醉进行配对研究。测定动脉压和SjvO2 。结果 :异丙酚组低碳酸性SjvO2 反应 (≥ 5 0岁 )显著低于其他各组 ;<5 0岁组则显著高于其他各组 (P <0 0 5 )。结论 :异丙酚维持神经外科手术在≥ 5 0岁病人低CO2

Objective:To investigate age related influence of propofol or isoflurane on SjvO 2 during hypercapnia and hypocapnia in neurosurgical patients.Methods:Anesthesia in propofol group was induced with propofol 2mg/kg,fentanyl 2μg/kg and atracurium 0 5mg/kg and maintained with propofol 6 10mg·kg -1 ·h -1 compared with paired patients with thiopental 5mg/kg for anesthesia induction and isoflurane (1 0 1 3MAC) for anesthesia maintenance.Arterial pressure through radial artery and SjvO 2 through internal jugular catheterization were assessed.Measurements were made in normocapnia,hypocapnia and hypercapnia.Results:Hypocapnia resulted in a significant SjvO 2 decrease in the ≥50 years old patients anesthetized with propofol compared with other patients,and SjvO 2 obvious increased in the <50 years old patients administered with propofol in contrast to other patients.Conclusion:Care should be taken during anesthesia with propofol associated with hypocarbia in neurosurgical patients great than 50 years old.