体外循环下冠脉旁路移植术的体会

Experiences of anesthesia about coronary artery bypass grafting under cardiopulmonary bypass

目的 10例冠心病患者在气管内麻醉下施行体外循环冠脉旁路移植术 (CABG )。方法 以大剂量芬太尼静脉麻醉为主 ,维持MAP 90～ 10 2mmHg ,HR 5 0～ 6 0bpm/min ,RPP <12 0 0 0。灌注用含钾晶体冷停跳液保护心肌 ,心脏复跳后输注正性肌力药、扩冠药。结果 术后无并发症 ,6例患者ECG示心肌缺血明显改善。结论 大剂量芬太尼静脉麻醉用于CABG是一种较好麻醉方法。

Objective To evaluate the value of a large dosage of fentany1 adminstration intravenously for coronary artery bypass graftingc (GABG) surgery. Methods 10 patients with coronary heart disease were scheduled for CABG under cardiopulmonary bypass and anesthesized mainly with a large dosage of fentany1.During anesthesia, MAP,HR,RPP were maintained at levels of 90～120 mmHg,50～60 bPm/min and <12 000,respectively. For myocardial protection, the hearts were perfused with cold crystal cardioplegia contained with postassium. Positive intropic and coronary artery-dilated medicines were used after the heart rebeat.Results After operation, no complications were found and ECG of 6 cases showed that myocardial ischemia had been improved.Conclusion Anesthesia with large dosage of fentanyl injected intravenously is a effective way for CABG surgery.