经食道心房调搏在麻醉监测中的应用-氟烷及异氟醚麻醉对人心内传导系统影响的比较研究

Transesophageal atrial pacing to monitor the influences of fluothane and isoflurane on human heart conduction system

作者应用经食道心房调搏研究了氟烷及异氟醚对人心内传导系统的影响。结果表明,诱导剂量的硫喷妥钠、安定、琥珀胆碱对心内传导系统无不良影响;氟烷及异氟醚可增进窦房传导功能,对窦房结自律性无不良影响;异氟醚可增进房室传导功能,氟烷则否;两药对房室束支及浦氏纤维均无影响。

The effects of fluothane and isoflurane on human heart conduction system(HCS) were studied with transesophageal in-cremental atrial pacing in 20 patients with ASA Ⅰ or Ⅱ.It was found that sodium thiopental 4 mg·Kg^(-1) diazepam 0.3 mg·kg^(-1) and succinylcholine 1.5 mg·kg^(-1) had no unfavorable influence on the HCS;the sion-atrial conduction time was short-ened during 1.5～2,2.1～3% fluothane and 1.5～2,2.1～3% isoflurane while the maximal sinus node recovery time,thecorrect sinus node recovery time and the siuns node recovery time intex were unchanged.The P-R interval and QRS complexwewe unchanged neither,but the rate of pacing inducing the wenckebach A-V conduction was increased during isoflurane in-haled while it did not so during fluothane inhaled The results indicate that both fluothane and isoflurane may improve the func-tion of sino-atrial conduction,but do not affect the S-A node automaticity;isoflurane may also improve the A-V conduction butfluothane does not,they do not influence the bundle branches.It suggests that both fluothane and isoflurane may be the anes-thetics of choice for patients with malfunction of the HCS and isoflurane may be ever better.