异丙酚复合咪唑安定对二尖瓣狭窄病人血流动力学的影响

目的　观察异丙酚复合咪唑安定对二尖瓣狭窄病人麻醉诱导期血流动力学的影响。方法　择期手术病人 2 0例 ,分别进行桡动脉和颈内静脉穿刺 ,置入 7 5F漂浮导管 ,麻醉诱导用咪唑安定 0 0 2mg/kg、异丙酚1mg/kg、芬太尼 10 μg/kg和阿端 0 1mg/kg。连续心排量监测HR、MAP、CVP、CI和SVI。 结果　诱导前后HR、MAP分别下降 17%± 5%和 15%± 7% ,PCWP由 2 59± 0 37降至 2 0 3± 0 12kPa ,而CI和SVI由 2 3± 0 2 0和2 17± 3 2升至 2 4± 0 2 1和 34 0± 6 7。结论　协同给予咪唑安定 0 0 2mg/kg和异丙酚 1mg/kg ,使异丙酚ED90减少达 4 5% ,更重要的是提高了二尖瓣狭窄病人的CI和SVI,病人心功改善同时 ,对肺动脉高压也有明显降低和缓解作用。

Hemodynamic Effect of Propofol Combined with Midazolam In-patient Undergoing Mitral Valve Replacement

Objective: To observe the hemodynamic effect of propofol combined with midazolam in-patient undergoing mitral valve replacement. Methods: 20 patients scheduled for mitral valve replacement received midazolam 0.02mg/kg and propofol 1mg/kg before anesthesia induction. The hemodynamic effects were observed at 2 min after propofol with the CCO-Baxter vigilance. Results: Propofol combined with midazolam caused a fall in HR and MAP within normal range. The cardiac index was increased and PCWP was lowered. Conclusion: 1mg/kg propofol combined with 0.02mg/kg midazolam may lead to a fall of 45% in propofol ED and fit for the patient with high pulmonary pressure.