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目的 比较地氟醚和异氟醚麻醉对小儿血液动力学的影响。方法 2 8例 1～ 5岁小儿 ,ASAⅠ～Ⅱ级 ,快速诱导气管插管后随机分为地氟醚 (D)和异氟醚 (I)两组 ,每组 14例。分别测量呼气末麻醉药浓度为 0、0 5、1 0和 1 5MAC稳定 5分钟后的SI、CI、SVR、HR及MAP。结果 与0MAC比较 ,0 5MAC时两组MAP和SVR均略有降低 (P <0 0 5 ) ,其他指标均无明显变化 (P >0 0 5 )。 1 0MAC时 ,SVR和MAP进一步降低 ,其幅度两组间无显著差异 ;HR和SI均略有升高 ,但无显著差异 ;CI值D组显著高于I组。达 1 5MAC时 ,D组的HR显著高于I组 ,而SI下降与 0MAC近似 ;SVR和MAP两组无进一步降低。结论 地氟醚和异氟醚麻醉对小儿心肌收缩功能均有一定抑制作用 ,但地氟醚使小儿HR增快的作用大于异氟醚
Objective To compare the effects of desflurane and isoflurane anesthesia on pediatric hemodynamics. Methods Twenty-eight children aged 1 to 5 years old, ASA Ⅰ ~ Ⅱ, were randomly divided into two groups: desflurane (D) and isoflurane (I). The SI, CI, SVR, HR and MAP were measured after the end-tidal anesthetic concentrations were 0, 5, 10 and 15 MACs for 5 minutes respectively. Results Compared with 0MAC, MAP and SVR of both groups were slightly decreased at 0 5MAC (P <0 05), while no significant changes were found on other indexes (P 0 05). At 10MAC, the SVR and MAP decreased further with no significant difference between the two groups; HR and SI both increased slightly, but no significant difference was found; CI D group was significantly higher than the I group. At 15MAC, the HR of group D was significantly higher than that of group I, while the decrease of SI was similar to that of 0MAC. There was no further decrease of SVR and MAP in both groups. Conclusion Both desflurane and isoflurane anesthesia can inhibit the myocardial contractile function in children, but the effect of desflurane on HR in children is faster than that of isoflurane