异丙酚和二氧化碳气腹对血压、心率、气道压和血浆一氧化氮水平的影响

观察异丙酚和二氧化碳气腹 (CO2 )对血压、心率、气道压和血浆一氧化氮 (NO)的影响。方法 :心肺功能正常的择期腹腔镜胆囊切除术 (LC)病人 2 0例 ,用异丙酚 2 .0mg/kg ,芬太尼 4ug/kg ,潘库溴胺0 .0 8mg/kg和琥珀胆碱 1.5mg/kg麻醉诱导 ,以微量泵匀速输注异丙酚 7mg·kg/h维持麻醉 ,记录诱导前、插管后 8min ,CO2 气腹后 2 0min和放气后 2 0min时心率 (HR)、平均动脉压 (MAP)和气道压 ,同时测定血浆NO的变化。结果和结论 :异丙酚和CO2 气腹对MAP、HR及血浆NO无明显影响 (P >0 .0 5 ) ;CO2 气腹致气道压升高 (P <0 .0 5 )。异丙酚可能具有一定的NO系统保护作用。

EFFECTS OF PROPOFOL AND CO2 PNEUMOPERITONIUM ON BLOOD PRESSURE HEART RATE, AIRWAY PRESSURE AND NITRIC OXID

Objective: Effects of propofol and CO 2 pneumoperitonium on blood pressure, heat rate, airway pressure and nitric oxid were studied in 20 patients with normal cardiopulmonary functions undergoing laparoscopic chlocystectomy (LC). Methods: Anesthesia was induced with propofol 2.0mg/kg, fentanyl 4ug/kg, pancuronium 0.08mg/kg and succinycholine 1.5mg/kg, and with the maintaining anesthesia of propofol 7mg.kg-1.h-1. MAP, HR, AP and No were recorded immediately before induction, 5 min after intubation, 20 min after CO 2 pneumoperitonium, 20 min after peritoneal deflation. Venous samples were taken at the same times to measure plasma concentrations of nitric oxid. Results: No significant changes of Bp, HR and No were observed. Airway pressure increased on CO 2 pneumoperitonium ( P <0.05). Conclusions: No significant changes of BP, HR and Nitric oxide were observed ( P >0.05). Airway pressure increased on CO 2 pneumoperitonium ( P <0.05). Propofol might protect nitric oxide from the regular balance system of nitric oxide.