非体外循环冠状动脉旁路移植术的麻醉管理

目的探讨非体外循环下冠状动脉旁路移植术病人的麻醉管理。方法择期非体外循环下冠状动脉旁路移植术病人20例,采用静吸复合全麻。硝酸甘油、艾司洛尔、去氧肾上腺素、多巴胺等用于调控血流动力学指标。观察术后患者血中心肌肌钙蛋白I（cTnI）和肌酸激酶同工酶（CK-MB）含量的变化。结果所有患者均顺利完成麻醉和手术,无麻醉并发症,预后良好。术后各时间点血中cTnI和CK-MB含量与术前比均有一定程度升高。结论非体外循环下冠状动脉旁路移植术心肌损伤轻,麻醉管理的关键是维持血流动力学平稳和心肌氧供与氧耗的平衡。

Anesthetic management of patients undergoing off-pump coronary artery bypass grafting

Objective To investigate the anesthetic management of patients undergoing off-pump coronary artery bypass grafting（OPCABG）.Methods Twenty patients underwent OPCABG were anesthetized.Nitroglycerin,Esmolol,Phenylephrine and Dopamine were used to control patients＇ hemodynamics.The changes of cTnI and CK-MB were analyzed in serum after operation.Results ALL patients had good recovery and prognosis without any anesthesia complications.The value of cTnI and CK-MB were increased significantly after operation.Conclusion OPCABG has minimal myocardial injury.The key of perioperative management of patients undergoing OPCABG depends on the maintenance of hemodynamics stability and the equilibrium between myocardial oxygenic supply and oxygenic consuming.