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BMC Anesthesiol：麻醉方案的选择并不会影响AVP对脑氧代谢和血流动力学的影响

2017-06-05 MedSci MedSci原创

脑氧代谢血流动力学AVP
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异丙酚-瑞芬太尼(P/R)复合麻醉下精氨酸加压素（AVP）的使用与颈静脉（SjvO2）和局部脑（rScO2）的氧饱和度减少有关。本研究旨在确定麻醉的情况下调节AVP对脑氧代谢和血流动力学的影响。 研究纳入了60名择期行肩部手术的成人患者，随机分成4组（BCP），分别在P/R或七氟醚氧化亚氮(S/N)麻醉下接受静脉注射生理盐水（PR-S 和 SN-S）或0.05 U/kg AVP（PR-AVP

异丙酚-瑞芬太尼(P/R)复合麻醉下精氨酸加压素（AVP）的使用与颈静脉（SjvO2）和局部脑（rScO2）的氧饱和度减少有关。本研究旨在确定麻醉的情况下调节AVP对脑氧代谢和血流动力学的影响。

研究纳入了60名择期行肩部手术的成人患者，随机分成4组（BCP），分别在P/R或七氟醚氧化亚氮(S/N)麻醉下接受静脉注射生理盐水（PR-S 和 SN-S）或0.05 U/kg AVP（PR-AVP和SN-AVP）（每组N = 15）。测定血流动力学变化、SjvO2 和 rScO2。

结果发现，各组AVP都可显著升高平均动脉压（MAP），并降低rScO2。AVP还可降低P/R组的SjvO2，但是S/N组并非如此。AVP治疗组显示较高的MAP和脑氧饱和度，HR及rScO2在BCP组较生理盐水组低。与此相反，AVP并不影响SjvO2值或SjvO2＜50%的发生率。基线时期SjvO2较低，且其降幅在BCP组较PR-AVP组和SN-AVP组大，最SjvO2值分别为37 ± 6和 57 ± 8% (P < 0.001)。

总而言之，该研究发现，麻醉方案的选择并不会影响BCP组AVP的脑氧代谢或血流动力学。然而，也应考虑AVP对脑氧合的负面影响，特别是在P/R麻醉中。

原始出处：

Eun-A Jang, Ji-A Song, et al., Background anaesthetic agents do not influence the impact of arginine vasopressin on haemodynamic states and cerebral oxygenation during shoulder surgery in the beach chair position: a prospective, single-blind study. BMC Anesthesiol. 2017; 17: 73. Published online 2017 May 30. doi:  10.1186/s12871-017-0364-9.

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    2017-12-15 ms3025846204744509

    #BMC#

    0

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    2018-01-14 xiangyuzhou971

    #EST#

    0

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    2017-10-22 仁心济世

    #血流动力#

    0

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    2017-06-07 zjshifan_98647306

    #血流动力学#

    0

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    2017-06-07 skhzy

    #ESI#

    0

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    2017-06-06 执着追梦

    学习，谢谢分享

    0

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    2017-06-05 楠博One

    麻醉副作用大

    0

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    2017-06-05 Y—xianghai

    学习了新知识

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