地氟醚和异氟醚麻醉对神经外科患者血液动力学及心肌肌钙蛋白Ⅰ的影响

Effects of desflurane & isoflurane on hemodynamics and cardiac troponin-Ⅰ in neurosurgical patients during anesthesia

目的 研究地氟醚和异氟醚麻醉对神经外科手术患者血液动力学及心肌肌钙蛋白Ⅰ (cTnⅠ )的影响。方法 选择神经外科手术患者 30例 ,随机分为对照组、地氟醚组和异氟醚组 ,每组各 10例。芬太尼、咪唑安定、异丙酚、维库溴铵麻醉下气管插管。Ⅰ组不给吸入麻醉药 ,Ⅱ组吸入地氟醚 ,Ⅲ组吸入异氟醚 ,记录麻醉前、麻醉后 30min、6 0min、90min、12 0min、术毕的SBp、DBp、HR、SPO2 、PETCO2 、ETAC。麻醉前、术毕、术后 2 4h抽静脉血 2ml检测cTnI。结果 患者麻醉后SBp、DBp均有下降 ,但差异无显著性。SPO2 、PETCO2 麻醉前后在正常值范围。术毕、术后 2 4hcTnⅠ比麻醉前升高 (P <0 0 5 ) ,但组间比较均差异无显著性。结论 地氟醚与异氟醚麻醉对血液动力学有一定影响 ,对cTnⅠ无明显影响 ,地氟醚与异氟醚麻醉对神经外科手术患者的血液动力学及cTnⅠ的影响相似。

Objective To study the effects of desflurane and isoflurane on hemodynamics and cardiac troponin-Ⅰ (cTnⅠ) in neurosurgical patients during anesthesia. Methods Thirty patients were randomly divided into three groups: group Ⅰ(without inhalation of anesthetics, n=10), groupⅡ (with inhalation of desflurane, n=10) and group Ⅲ (with inhalation of isoflurane, n=10). All the patients were induced with fentanyl, midazolum, propofol and vecuronium bromide and were endotrachointubated. SBp,DBp,HR,SPO_2,PETCO_2,ETAC were recorded before anesthesia and at 30min, 60 min, 90 min, 120 min after anesthesia respectively .The venous blood samples were taken to measure the serum levels of cTnⅠbefore anes thesia ,upon completion of operation and 24h after operation .Results In the three groups,SBp and DBp de creased after anesthesia ,but difference was not significant.SPO2 and PETCO2 were normal before and after anesthesia .Serumc TnⅠthe level was significantly higher upon completion of operation and 24h after operation than before anesthesia (P <0 0 5 ) .But the difference within and between groups was not significant.Conclu sions Desflurane and isoflurane may have some effects on the hemodynamics in the neurosurgical patients dur ing anesthesia ,but both have no significant effects on cTnⅠ .Effects of desflurane and isoflurane on hemody namics and cTnⅠare similar .