J C Peyrin, C Arvieux, P Girardet, J M Fargnoli, P Stieglitz
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引用次数: 0
摘要
我们对心脏手术患者的麻醉记录进行了回顾性研究:Stanley(29)指出,他们使用了大剂量的芬太尼。芬太尼诱导剂量为150微克/千克,维持剂量为15 ~ 25微克/千克/小时,泮库溴铵诱导剂量为0.1毫克/千克,维持剂量为0.015毫克/千克/小时。诱导期心肌耗氧量(由速率-压力-积估算)保持不变。与其他麻醉技术相比,该方法的食道-直肠温度梯度较小,无需血管扩张剂,灌注均匀性良好。搭桥后的体温下降也降低了(低于1.2℃)。手术期间和术后第一天血液动力学和节律紊乱的发生率降低。延迟呼吸自主似乎是这种方法的主要缺点(组1:25,30小时+/- 7,30小时;30、20 h +/- 12、25 h;组3:21,15 h +/- 6,25 h)。
[Fentanyl-oxygen-pancuronium anaesthesia in cardiac surgery (author's transl)].
A retrospective study of the anaesthetic records in cardiac surgical patients was undertaken: massive doses of fentanyl were used according to Stanley (29). The rate of drug administration was fentanyl 150 micrograms/kg for induction and 15 to 25 micrograms/kg/hour for maintenance, pancuronium bromide 0,1 mg/kg for induction and 0,015 mg/kg/hour for maintenance. Myocardial oxygen consumption (estimated by rate-pressure-product) during induction period remains constant. The oesophago-rectal temperature gradient is smaller than with other anaesthetic techniques, showing a very good perfusion homogeneity without the need of vasodilatator drugs. The temperature after-drop in the post bypass period is also reduced (less than 1,2 degrees C). The incidence of hemodynamic and rhythmic disturbances during operations and during the first post-operative day is lowered. Delayed respiratory autonomy appears to be the major drawback of this method (group 1: 25,30 h +/- 7,30 h; 30,20 h +/- 12,25 h; group 3: 21,15 h +/- 6,25 h).