异氟醚对眼部血液动力学的影响

目的 研究异氟醚对眼部血液动力学的影响。方法 选择无明显眼部疾病的成年非头颈手术患者１５例，静脉注射异丙酚、阿曲库铵快速诱导麻醉，插入喉罩，吸入异氟醚维持麻醉，采用彩色多普勒成像仪（ＣＤＩ）预测麻醉前、异氟醚１ＭＡＣ和１．５ＭＡＣ３０ｍｉｎ后的双眼动脉（ＯＡ）、视网膜中央动脉（ＣＲＡ）和睫状后动脉（ＰＣＡ）的收缩期峰流速（ＰＳＶ）、舒张期末流速（ＥＤＶ）、平均流速（Ｔｍａｘ）和阻力指数（ＲＩ）及血

Effects of isoflurane on ocular hemodynamics

Objective To observe the effects of isoflurane on ocular hemodynamics .Methods Fifteen patients without eye diseases undergoing non-head and non-neck surgical procedures ,were enrolled in this study. Anesthesia was induced with intravenous propofol and atracuronium, followed by laryngeal mask insertion, and was maintained with isoflurane. Peak systolic velocity(PSV),end diastolic velocity(EDV),Tmax and resistant index(RI) of double ophthalmic arteries, central retinal artery and posterior ciliary arteries were determined by coloured Doppler imaging before anesthesia, 30 min following inhalation of isoflurane 1.0MAC or 1.5MAC respectively . Blood pressure, heart rate and SpO 2 were also measured at above time points.Results As compared with those before anesthesia ,no significant changes were found in all above parameters of double ocular arteries in all time points; PSV and EDV of central retinal artery decreased significantly with increase of isoflurane level(P< 005), but without significant changes in RI(P>005); all above parameters of posterior ciliary artery decreased significantly ,with increase of isoflurane level(P< 005),but without significant changes in RI(P>005). The diastolic pressure was positively correlated with PSV and EDV of central retinal artery and posterior ciliary arteries ,and negatively with RI , but no correlation to all above parameters of double ophthalmic arteries.Conclusions It may be dangerous for the patients with potential ischemia of eyes undergoing isoflurane anesthesia. Decreasing its concentration and improving blood pressure can increase ocular blood supply to prevent ophthalmic ischemic complications from occurrence.