低浓度地氟醚对全麻病人血液动力学和纤溶功能影响

Effect of low concentration desflurane on hemodynamics and fibrinolysis in patients with elective chest surgery during general anesthesia

目的 :观察低浓度地氟醚吸入对全麻病人血液动力学和纤溶功能的影响。方法 :择期胸部手术病人 2 8例 ,ASAⅠ～Ⅱ级。麻醉诱导后气管插管 ,观察 0 .5、1 .0MAC地氟醚对病人血液动力学和纤溶功能的影响。结果 :麻醉诱导后气管插管时 ,病人SBP、DBP和MAP均呈显著性下降 ,HR显著增快 (P均 <0 .0 1 )。分别吸入 0 .5、1 .0MAC地氟醚时 ,虽收缩压 (SBP)、舒张压 (DBP)、平均动脉压 (MAP)较麻醉前明显下降 (P <0 .0 5 ) ,但与麻醉诱导后相比 ,血压未见进一步降低 ;心率 (HR)虽较麻醉前增快 ,但与气管插管后比较 ,HR有所减慢。吸入 0 .5MAC地氟醚后 ,血浆t PA含量明显增加 ,而血浆PAI水平则显著降低 ,随地氟醚吸入浓度 (1 .0MAC)的增加 ,血浆t PA含量进一步增加 ,血浆PAI含量进一步降低。结论 :0 .5、1 .0MAC地氟醚对全麻病人血液动力学有一定的影响 ,可增强机体的纤溶功能。

AIM: To investigate the effect of low concentration desflurane on hemodynamics and fibrinolysis in patients during general anesthesia. METHODS: Twenty eight ASA grade Ⅰ-Ⅱ patients during general anesthesia, scheduled for elective chest surgery, were studied, and hemodynamics and fibrinolysis were observed after inhalation of desflurane at 0.5 and 1.0 MAC , respectively. RESULTS: Compared with those before anesthesia, SBP, DBP, and MAP remarkably decreased and HR significantly increased at intubation. However, the changes were more remarkable than those of before anesthesia when inhalation of desflurane at 0.5 and 1.0 MAC ; blood pressure did not further decreased; and HR did not increased in comparison with intubation. The level of plasma tissue plasminogen activator (t PA) remarkably increased and the level of plasma plasminogen activitor inhibitor (PAI) significantly decreased when inhalation of desflurane. The level of plasma t PA further increased and the level of plasma PAI further decreased as inhalation of increased desflurane concentration. CONCLUSION: There are some effects of low concentration desflurane on hemodynamics and fibrinolysis in patients with chest surgery during general anesthesia.