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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Midazolam-sufentanil vs sufentanil-enflurane for induction of anaesthesia for CABG surgery.
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Midazolam-sufentanil vs sufentanil-enflurane for induction of anaesthesia for CABG surgery.

机译：咪达唑仑-舒芬太尼vs舒芬太尼-恩氟烷用于CABG手术的麻醉诱导。

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PURPOSE: To compare the effects of midazolam-sufentanil (Group I) and sufentanil-enflurane (Group II) anaesthesia on myocardial oxygenation and metabolism in patients with preserved ventricular function undergoing CABG surgery. METHODS: Patients randomized to Group I (n = 16) received midazolam 0.3 mg.kg-1 at induction of anaesthesia, 0.15 mg.kg-1 after tracheal intubation, followed by an infusion of 2.5-10.0 micrograms.kg-1.min-1. Supplemental sufentanil (cumulative maximum of 5 micrograms.kg-1) was given for adverse haemodynamic responses. Group II (n = 16) received 5 micrograms.kg-1 sufentanil at induction. Additional sufentanil (maximum 5 micrograms.kg-1), and enflurane (0-3% inspired concentration) were administered for adverse haemodynamic responses. Haemodynamics, myocardial oxygen consumption (MVO2), and lactate extraction were determined at the following times: I) awake (AWA), 2) after induction (IND), and 3) after tracheal intubation (ETT). RESULTS: Systemic haemodynamics and myocardial metabolism were similar at AWA. Heart rate response was attenuated and MVO2 reduced in Group I at IND (P < 0.05). Following AWA, myocardial lactate production (MLP) occurred more frequently in Group II vs Group I patients (9/16 vs 2/16) and at more individual measurement points (Group II: 10/64 vs Group I: 3/64). Myocardial lactate flux demonstrated a deleterious trend in Group II at ETT. CONCLUSIONS: Compared with sufentanil-enflurane, midazolam-sufentanil anaesthesia resulted in comparable and acceptable haemodynamics and myocardial oxygenation in CABG patients.
机译：目的：比较咪达唑仑-舒芬太尼（I组）和舒芬太尼-安氟醚（II组）麻醉对CABG手术保留心室功能的患者心肌氧合和代谢的影响。方法：随机分组到I组（n = 16）的患者在麻醉诱导下接受咪达唑仑0.3 mg.kg-1，气管插管后接受0.15 mg.kg-1，然后输注2.5-10.0μg.kg-1.min -1。补充舒芬太尼（累计最大5微克.kg-1）用于不良血流动力学反应。第二组（n = 16）在诱导时接受了5微克kg-1舒芬太尼。给予额外的舒芬太尼（最大5微克.kg-1）和安氟烷（0-3％吸入浓度）以应对不良的血液动力学反应。在以下时间测定血流动力学，心肌耗氧量（MVO2）和乳酸提取：I）清醒（AWA），2）诱导后（IND）和3）气管插管（ETT）后。结果：AWA的全身血流动力学和心肌代谢相似。 I组在IND时心率反应减弱，MVO2降低（P <0.05）。 AWA后，II组患者与I组患者（9/16对2/16）相比，心肌乳酸生成（MLP）的发生频率更高，并且在单独的测量点上更为明显（II组：10/64与I组：3/64）。 ETT的II组心肌乳酸通量显示出有害的趋势。结论：与舒芬太尼-安氟醚相比，咪达唑仑-舒芬太尼麻醉可使CABG患者的血流动力学和心肌氧合相当且可接受。

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