地氟烷或异氟烷维持脑肿瘤手术时颈静脉球血氧饱和度

目的 :观察等效浓度地氟烷和异氟烷维持麻醉对脑肿瘤手术患者颈内静脉球血氧分压 (Pj O2 )、血红蛋白氧饱和度(Sj O2 )和动脉 -颈内静脉球血氧含量差 (Aj DO2 )的影响。方法 :5 6例幕上脑肿瘤患者随机分配到地氟烷组 (n=2 8)和异氟烷组(n=2 8)。两组麻醉诱导方法相同 ,分别以 1.3MAC的地氟烷 (7.8% )和 1.3MAC异氟烷 (1.5 % )维持麻醉 ,并分别观察患者在正常通气、过度通气和通气不足时 Pj O2 、Sj O2 和 Aj DO2 的变化。 结果 :正常通气时 Sj O2 和 Pj O2 在地氟烷组均显著高于异氟烷组 (P<0 .0 5或 P<0 .0 1) ;Aj DO2 在地氟烷组显著低于异氟烷组 (P<0 .0 5 )。除过度通气时 Pj O2 在地氟烷组显著高于异氟烷组 (P<0 .0 1)外 ,过度通气和通气不足时 ,Sj O2 、Pj O2 和 Aj DO2 在两组之间无显著差异。另外 ,两组患者 Sj O2 与 Pa CO2 之间均呈显著正相关 (r=0 .84,r=0 .76 ,P<0 .0 5 )。结论 :等效浓度的地氟烷较异氟烷在正常通气时有增加 Sj O2 和 Pj O2 的作用 ,提示地氟烷扩张脑血管的作用可能强于异氟烷

Jugular bulb oxygen saturation during desflurane and isoflurane anesthesia in pa tients undergoing brain tumor surgery

Objective: To investigate jugular bulb venous oxygen partial pressure(PjO 2), hemoglobin saturation (SjO 2) and the arterial to jugular bulb venous oxygen content difference(AjDO 2) during anesthesia with desflurane and isoflurane in patients with brain tumor. Methods: Fifty six patients with brain tumor were randomized into desflurane or isoflurane for maintaining anesthesia. PjO 2, SjO 2 and AjDO 2 in patients were measured during normoventilation, hyperventilation and hypoventilation. Results: During normoventilation, SjO 2 and PjO 2 in desflurane group was significantly higer than those in isoflurane group( P <0.05 or P <0.01), and AjDO 2 in desflurane group was significantly lower than that in isoflurane group( P <0.05).Except that PjO 2 in desflurane group was significantly higer than that in isoflurane group during hyperventilation ( P <0.01), there were no differences in SjO 2, PjO 2 or AjDO 2 between the 2 groups during hyperventilation or hypoventilation. While anesthesia with desflurane and isoflurane, there was a positive correlation between PaCO 2 and SjO 2. Conclusion: At the same anesthetic effect concentration, desflurane can significantly increase SjO 2 and PjO 2 in comparison to isoflurane under normoventilation, suggesting that desflurane may have stronger effect of relaxing cerebral vessel than isoflurane.