七氟烷联合利多卡因对全身麻醉患者心功能影响研究

Effects of Sevoflurane Combined with Lidocaine on the Cardiac Function of Patients with General Anesthesia

目的:通过观察七氟烷联合利多卡因对全身麻醉患者心功能影响,探究七氟烷联合利多卡因诱导全身麻醉的临床价值。方法:选取我院外科收治的需行非心脏手术并进行全身麻醉诱导的患者70例,随机分为两组,其中对照组35例,予单纯七氟烷诱导全身麻醉行非心脏手术;实验组35例,予以七氟烷联合利多卡因进行全身麻醉诱导。分别于全身麻醉诱导前(T1)、诱导插管后30分钟(T2)、诱导插管后1小时(T3)3个时间点对患者心功能进行观察和监测,对比观察各个时间点的外周血管阻力(SVR)、每搏输出量(SV)、每分输出量(CO)、峰值速度(Vp K)、心率(HR)、净射血时间百分比(ET%)等指标。结果:1实验组和对照组患者在T1时SVR、SV、CO、Vp K、HR、ET%水平均无明显变化,差异无统计学意义(P<0.05);2与T1相比,实验组和对照组患者在T2和T3的SVR、SV、CO、Vp K、HR水平均明显下降,差异有统计学意义(P<0.05),ET%升高明显,差异有统计学意义(P<0.05);3实验组在T2和T3时SVR、SV、CO、Vp K、HR水平均明显高于对照组,差异有统计学意义(P<0.05),ET%较对照组明显下降,差异有统计学意义(P<0.05)。结论:单纯七氟烷诱导和七氟烷联合利多卡因诱导全身麻醉对心功能均有影响,但与单纯七氟烷组相比,七氟烷联合利多卡因组对心功能的影响更小,更适合于外科手术的全身麻醉诱导,对临床具有指导意义,值得临床推广。

Objective： To investigate the effects of sevoflurane combined with lidocaine on the cardiac function of patients with general anesthesia. Methods： 70 cases of patients needed to carry on non cardiac surgery under the induction of general anesthesia were selected, and randomly divided into two groups, 35 cases in each group. The control group was treated with pure sevoflurane induction of general anesthesia for heart surgery; while the experimental group was treated with general anesthesia of sevoflurane joint lidocaine. The cardiac function was observed and monitored respectively before the systemic narcotic induction （TI）, 30 minutes after intubation induction （T2）, 1 hour after inducing intubation （T3） three time points. The peripheral vascular resistance （SVR）, stroke volume （SV） output, per minute output （CO）, peak velocity （VpK）, heart rate （HR）, and net percentage ejection time （ET） % were compared at each time point between the two groups. Results： （1）The level of SVR, SV, CO, VpK, HR, ET % level had no obvious change at T1 in the experimental group and control group （P〈0.05）; （2） compared with T1, the level of SVR, SV, CO, VpK, HR at T2 and T3 were significantly lower in the two groups with statistical significance （P〈0.05）, and ET % was increased significantly （P〈0.05）; @compared with that in the control group, the level of SVR, SV, CO, VpK, HR in experimental group at T2 and T3 were significantly higher, and the difference was statistically significant （P〈0.05）, while ET % was significantly decreased, and the difference was statistically significant （P〈0.05）. Conclusions： The general anesthesia with pure sevoflurane induction or sevoflurane combined with lidocaine affected the cardiac function, but compared with the pure sevoflurane induction, sevoflurane combined with lidocaine had a minimal impact on cardiac function, indicating it is more suitable for induction of general anesthesia surgery.