Effects of general anesthesia by TCI sufentanil and propofol on intrapulmonary shunt during one-lung ventilation

WANG Hong-tao1; LENG Yu-fang1; QIAN Jing-di2

doi:10.13406/j.cnki.cyxb.2011.07.023

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Effects of general anesthesia by TCI sufentanil and propofol on intrapulmonary shunt during one-lung ventilation

更新时间：2024-01-17

- Effects of general anesthesia by TCI sufentanil and propofol on intrapulmonary shunt during one-lung ventilation
- Journal of Chongqing Medical University Vol. 36, Issue 7, Pages: 860-862(2011)
- 作者机构：
  
  1. 兰州大学第一医院麻醉科
  2. 昆明市延安医院心胸外科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2011.07.023
  CLC： R614.2
- Published：2011，
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[1]王洪涛,冷玉芳,钱金娣.舒芬太尼复合异丙酚靶控输注对单肺通气肺内分流的影响[J].重庆医科大学学报,2011,36(07):860-862.

WANG Hong-tao1, LENG Yu-fang1, QIAN Jing-di2. Effects of general anesthesia by TCI sufentanil and propofol on intrapulmonary shunt during one-lung ventilation. [J]. Journal of Chongqing Medical University 36(7):860-862(2011)
[1]王洪涛,冷玉芳,钱金娣.舒芬太尼复合异丙酚靶控输注对单肺通气肺内分流的影响[J].重庆医科大学学报,2011,36(07):860-862. DOI： 10.13406/j.cnki.cyxb.2011.07.023.

WANG Hong-tao1, LENG Yu-fang1, QIAN Jing-di2. Effects of general anesthesia by TCI sufentanil and propofol on intrapulmonary shunt during one-lung ventilation. [J]. Journal of Chongqing Medical University 36(7):860-862(2011) DOI： 10.13406/j.cnki.cyxb.2011.07.023.

摘要

目的:研究舒芬太尼-异丙酚靶控静脉麻醉与异氟醚麻醉对单肺通气（One-lung ventilation

OLV）肺内分流和肺顺应性（Dynamic compliance of lung

Cdyn）的影响。方法:择期行中、下段食管癌根治手术患者20例

ASAⅠ～Ⅱ级

随机分为2组（n=10）:舒芬太尼-异丙酚组（SUF组）

靶控输入效应室浓度为0.5 ng/ml舒芬太尼和3μg/ml异丙酚麻醉;异氟醚组（ISO组）

吸入1%～3%异氟醚维持麻醉。分别于麻醉后双肺通气30 min（T0）、单肺通气30 min（T1）、60 min（T2）、90 min（T3）等4个时间点经桡动脉、颈内静脉采血做血气分析

计算肺内分流率（Qs/Qt）和Cdyn。结果:与T0时点相比

2组Qs/Qt在T1～T3时点显著增加（P<0.05）

Cdyn在T1～T3时点显著降低（P<0.05）;与ISO组相比

SUF组Qs/Qt在T1～T3时点降低（P<0.05）

Cdyn在T1～T3时显著增加（P<0.05）。与T0时点相比

PaO2在OLV后明显下降（P<0.05）

组间相比

差异无统计学意义（P>0.05）。结论:舒芬太尼-异丙酚靶控静脉麻醉在开胸手术施行OLV期间可减少肺内分流

增加Cdyn

但对PaO2的影响不明显。

Abstract

Objective:To investigate the difference effects in intrapulmonary shunt and pulmonary dynamic compliance between sufentanil-propofol by target-controlled infusion and isoflurane during one-lung ventilation.Methods:Twenty ASA ⅠorⅡ patients undergoing radical esophagus cancer resection via left thoracotomy were randomly divided into 2 equal groups(n=10 each):the sufentanil and propofol group(SUF) and the isoflurance group(ISO).In SUF group anesthesia was maintained with TCI of sufentanil and propofol(targeting effect-site concentration was set at 0.5 ng/ml and 3(g/ml);In ISO group

anesthesia was maintained with isoflurance.Arterial and pulmonary blood gases were analyzed 30 min after TLV was started(T0)

and 30

90 min after OLV was started(T1

T3).The intrapulmonary shunt fraction(Qs/Qt) and pulmonary dynamic compliance(Cdyn) was calculated at T0-T3.Results:The PaCO2 and pH were within normal range in both groups.Qs/Qt was significantly increased while PaO2 and Cdyn was significantly decreased during operation(from T1 to T3)as compared to baseline values(T0)

but Qs/Qt decreasing while PaO2 was increasing from T2-T3 in both groups.Qs/Qt was significantly lower in SUF group than in ISO group at each interval(T1-T3)

Cdyn was significantly high in SUF group than ISO group at each interval(T1-T3)but there no significant difference in PaO2 at T2-T3 between the two groups.Conclusion:Compared with isoflurane anesthesia

there is less intrapulmonary shunt and high pulmonary dynamic compliance during OLV under general anesthesia with sufentanil-propofol

but the difference is not significant enough to affect PaO2.

关键词

舒芬太尼肺循环靶控输注麻醉

Keywords

sufentanilpulmonary circulationtarget-controlled infusiongeneral anesthesia

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