七氟醚和异氟醚心血管效应的比较

Comparative study of effects of sevoflurane and isoflurane on cardiovascular system

目的 比较不同浓度七氟醚和异氟醚的心血管效应 .方法 2 0只健康杂种犬随机分为七氟醚组和异氟醚组 .监测有创动脉压 ;经大静脉置入漂浮导管测定肺动脉楔压、中心静脉压、心输出量 .吸入麻醉药 (七氟醚或异氟醚 ) ,维持其呼气末浓度在 14.5 m L· L- 1 或 8.5 m L· L- 1 ,10 min后测定上述参数值 .结果 七氟醚和异氟醚 :1对心率均没有显著影响 ;2均可呈剂量依赖性地降低体循环血压和血管阻力 ,对心功能也有剂量依赖性的抑制作用 ,两药之间的差异没有显著性 ;3七氟醚降低肺动脉压的作用强于异氟醚 ,但与浓度大小无明显关系 .结论 七氟醚和异氟醚具有相似的心血管效应 ,除七氟醚降低肺动脉压的作用强于异氟醚外 ,二药对心血管系统功能均有剂量依赖性的抑制作用 .

AIM To study the cardiovascular effects of sevoflurane and isoflurane comparatively. METHODS 20 healthy dogs were randomly divided into sevoflurane group (Group A: 10 dogs) and isoflurane group (Group B: 10 dogs). The invasive blood pressure and electrocardiograph were monitored in all dogs. The mean pulmonary arterial pressure, pulmonary arterial wedge pressure, centravenous pressure and cardiac output were monitored through Swan Ganz catheter. The basal values of the above indices were determined firstly; Sevoflurane (or isoflurane) was adjusted to maintain its end expiratory concentration to 14.5 mL·L -1 for Group A and 8.5 mL·L -1 for Group B (or 29.0 mL·L -1 for Group A or 17.0 mL·L -1 for Group B) for at least 10 min, then the above mentioned indexes were determined again, and then inhaling anesthetic was terminated. All indexes returned to the level of the basal value after each step ended. RESULTS ① No significant changes occurred to heart rate when sevoflurane or isoflurane was used. ②Sevoflurane and isoflurane could inhibit arterial blood pressure, systemic vascular resistance as well as the cardiac function in a dose dependent fashion, and no significant difference existed between two groups. ③ The decrease of pulmonary arterial pressure was more in Group A than in Group B, but no significant relationship to the concentrations of the two anesthestics; And no effect occurred to pulmonary vascular resistance. ④Low concentration of sevoflurane or isoflurane had no influence on pulmonary arterial wedge pressure, centravenous pressure, but high concentration with increasing pulmonary arterial wedge pressure, centravenous pressure. CONCLUSION Sevoflurane and isoflurane may have similar inhibitory action on cardiovascular function in a dose dependent fashion except that sevoflurane has more inhibitive action on pulmonary arterial pressure than isoflurane.