麻醉诱导期间局部脑组织氧饱和度的变化

Changes in oxygen saturation of regional cerebral tissue during anesthesia induction

目的研究乳腺癌手术患者从麻醉开始至诱导后30 min,由靶控输注丙泊酚诱导麻醉下局部脑组织氧饱和度(rScO_(2))的变化。方法选取2016年1-4月于我院行乳腺癌根治手术的30例女性患者作为研究对象进行队列研究,评估从麻醉诱导开始到诱导后30 min过程中rScO_(2)的变化。将患者额头左右两侧的rScO_(2)值取平均值,以便根据FORE-SIGHT数据直接确定脑氧合。同时测量麻醉诱导后30 min内每分钟的平均动脉压(MAP),心率(HR),动脉血氧分压(PaO_(2)),动脉血二氧化碳分压(PaCO_(2)),血红蛋白浓度(Hb)和心输出量(CO)。结果7 min时的平均rScO_(2)为81.7%,高于基线时(67.3%)和15 min时的平均rScO_(2)(68.3%)。在麻醉诱导的前7 min内,平均rScO_(2)与PaO_(2)显著相关。结论在麻醉诱导过程中,rScO_(2)的变化在7 min时达到峰值,可能与PaO_(2)的增加呈正相关。

Objective To study the changes in rScO_(2) under anesthesia induced by a target control infusion of propofol from the beginning of anesthesia to 30 minutes after induction in patients undergoing breast cancer surgery.Methods A total of 30 female patients treated from January to April 2016 in our hospital were included in this cohort study to evaluate the changes in rScO_(2) from the beginning of anesthesia to 30 minutes after induction.The rScO_(2) values from the right and left sides of patients′foreheads were averaged to directly determine cerebral oxygenation based on FORE-SIGHT data.Mean arterial pressure(MAP),heart rate(HR),partial pressure of oxygen in arterial blood(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2)),hemoglobin concentration(Hb),and cardiac output(CO)were measured every minute until 30 minutes after anesthesia induction.Results The average rScO_(2) at 7 minutes was 81.7%,which was higher than the average rScO_(2) at baseline(67.3%)and at 15 minutes(68.3%).Average rScO_(2) correlated significantly to PaO_(2) during the first 7 minutes of anesthesia induction.Conclusion During anaesthesia induction,changes in rScO_(2),which increases to a peak value at 7 minutes,may be positively correlated with increase in PaO_(2).