目的:观察七氟醚靶控用于低流量吸入麻醉维持的临床规律及血流动力学变化,寻求靶控下的药物量化指标。方法:选择60例20～60岁手术患者,随机分2组每组30例:P组(丙泊酚)常规实施全凭静脉TCI靶控麻醉;S组(七氟醚),实施低流量七氟醚靶控吸入麻醉(BIS值40)。分别记录诱导前(T1),插管后5(T2)、15(T3)、30(T4)45(T5)、60(T6)、90(T7)、120(T8)min时的、MBP、HR、;Sev组患者加记各个时点的七氟醚IT、ET的MAC值。结果:T2点两组均比T1 降低(Plt;0.05),S 组高于P组(Plt;0.05),两组比较T3至T7无显著性差异(Pgt;0.05);S 组T3 至T7 各点ET值无统计学差异,ET%:2.46,约1.4 MAC。结论:(1)七氟醚诱导较静脉麻醉诱导患者血流动力学稳定,(2)低流量七氟醚靶控吸入麻醉维持平稳,调控简便,效果良好。
ObjectiveTo evaluate the feasibility to use ultrasonic cardiac output monitoring (USCOM) for patients after coronary artery bypass grafting. MethodsClinical data of 32 patients undergoing off-pump coronary artery bypass grafting in General Hospital of Shenyang Military Region between April and June 2013 were retrospectively analyzed. There were 17 male and 15 female patients with their age of 46-76 (63.2±7.6) years. USCOM and pulmonary artery catheterization (PAC) were used to measure cardiac output (CO) synchronously,and the results were compared between USCOM and PAC. ResultsSixty-four pairs of data were collected from those 32 patients. No adverse event was observed with either USCOM or PAC. Mean CO was 4.27±0.92 L/min with USCOM and 4.49±0.75 L/min with PAC respectively,which were not statistically different (P=0.12) but significantly correlated (r=0.84,P<0.001). ConclusionThere is close correlation between USCOM and PAC for CO measurement. USCOM can not only measure CO accurately,but also has the advantages of being noninvasive,easy to perform and low cost.