芬太尼复合麻醉对心脏手术病人脑血流动力学的影响

Effect of Fentanyl Anaesthesia on Cerebral Blood Flow Kinetics of Patients Undergoing Cardiac Operation

目的应用经颅多谱勒 (TCD)研究芬太尼复合麻醉对心脏手术病人脑血流动力学的影响。方法2 4例择期心脏手术病人 ,采用TCD监测右侧大脑中动脉血流速率 (V -MCA) ,同时监测血压、呼末二氧化碳分压 (PetCO2 )和脉搏氧饱和度(SpO2 ) ,搏动指数 (PI)。分别于麻醉前后记录。维持PetCO2 和SpO2 正常范围。结果与麻醉前比 ,麻醉后脑血流速率下降 31%～ 35 %(P <0 .0 1) ,PI增加 2 2 % (P <0 .0 1)。MPA下降 10 %。结论芬太尼复合麻醉可降低脑血流速率 。

ObjectiveTo study the effect of fentanyl anesthesia on cerebral blood flow kinetics by transcranial Doppler sonography(TCD) in adult patients undergoing cardiac operation.Methods Blood flow velocity of middle cerebral artery (V-MCA) in twenty-four adult patients undergoing cardiac valve replacement were measured by TCD and recorded before(baseline)and after anesthesia. Mean artery pressure (MAP),pulse oximetry(SpO 2) and pressure of end-tidal carbon dioxide(Pet CO 2)were monitored at the same time. SpO 2 and Pet CO 2 were maintained in a normal range (96%～100% and 35-45 mm Hg) respectively.ResultsAfter anesthesia, the peak V-MCA(Vm-MCA)decreased 31%～35%(P<0.01), MPA decreased 10% and the pulsatility index(PI)of middle cerebral artery increased 22%(P<0.01) as compared with their baselines.ConclusionThe results suggest that fentanyl anesthesia can decrease V-MCA and cerebral blood flow volume. [