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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Nitrous oxide produces minimal hemodynamic changes in patients receiving a propofol-based anesthetic: an esophageal Doppler ultrasound study: (Le protoxyde d'azote produit des changements hemodynamiques minimes chez des patients qui recoivent une ane
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Nitrous oxide produces minimal hemodynamic changes in patients receiving a propofol-based anesthetic: an esophageal Doppler ultrasound study: (Le protoxyde d'azote produit des changements hemodynamiques minimes chez des patients qui recoivent une ane

机译：一氧化二氮对接受异丙酚麻醉的患者的血流动力学变化影响最小：一项食道多普勒超声研究：（一氧化二氮对接受驴的患者的血流动力学变化影响最小

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PURPOSE: Nitrous oxide (N(2)O) is a frequently used adjunct to propofol anesthesia. Although N(2)O reduces the requirement of propofol for induction and maintenance, the effects of both drugs on overall hemodynamics remain controversial. We tested the hypothesis that the addition of N(2)O to therapeutic doses of propofol alters hemodynamics and Doppler-derived variables evaluated with the esophageal Doppler monitor in a randomized, double-blinded, placebo-controlled design. METHODS: Thirty ASA I-II patients (aged 30-66 yr) were randomly assigned to receive propofol with oxygen-enriched air (FIO(2) = 0.3; air group) or propofol with 70% N(2)O (N(2)O group). Following intubation, a computerized target-controlled infusion technique was used to administer propofol from 0 micro g*mL(-1) (baseline) to 5 micro g*mL(-1) in 1 micro g*mL(-1) increments. RESULTS: Mean arterial pressure (MAP) decreased more in the N(2)O group than in the air group only at 5 micro g*mL(-1). Aortic blood flow (ABF) showed a similar dose-dependent decrease in both groups. Peak aortic flow acceleration, as a myocardial contractility index, decreased significantly and similarly in both groups in a dose-dependent manner whereas peak velocity of ABF, as another measure of myocardial contractility, remained unchanged. Heart rate-corrected left ventricular ejection time, as a measure of preload, remained constant in both groups at any target plasma concentration. CONCLUSION: Propofol causes dose-dependent decreases in ABF and MAP; however, 70% N(2)O produces minimal hemodynamic and Doppler-derived variable changes under target-controlled propofol infusion at therapeutic concentrations.
机译：目的：一氧化二氮（N（2）O）是丙泊酚麻醉的常用辅助剂。尽管N（2）O降低了异丙酚的诱导和维持需求，但两种药物对总体血液动力学的影响仍存在争议。我们测试了以下假设：在随机，双盲，安慰剂对照设计中，向治疗剂量的异丙酚中添加N（2）O会改变食道多普勒监测仪评估的血流动力学和多普勒衍生变量。方法：30名ASA I-II患者（年龄30-66岁）被随机分配接受富含氧气的丙泊酚（FIO（2）= 0.3;空气组）或接受70％N（2）O（N（ 2）O组）。插管后，使用计算机化的靶控输注技术以1 micro g * mL（-1）的增量从0 micro g * mL（-1）（基线）至5 micro g * mL（-1）施用异丙酚。结果：仅在5 micro g * mL（-1）时，N（2）O组的平均动脉压（MAP）下降比空气组下降更多。两组的主动脉血流量（ABF）均显示相似的剂量依赖性下降。两组的主动脉血流峰值加速显着降低，且呈剂量依赖性，并且相似地下降，而作为心肌收缩力的另一指标，ABF的峰值速度则保持不变。两组心率校正后的左心室射血时间（作为预负荷的量度）在任何目标血浆浓度下均保持不变。结论：异丙酚引起ABF和MAP的剂量依赖性降低;然而，在控制浓度的丙泊酚输注下，在治疗浓度下，有70％的N（2）O产生最小的血流动力学和多普勒衍生的变量变化。

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