Pulmonary mechanics during isoflurane, sevoflurane and desflurane anaesthesia
Pulmonary mechanics during isoflurane, sevoflurane and desflurane anaesthesia
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DOI：
10.1046/j.1365-2044.2003.03285.x
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发表时间：
2003-08-01
期刊：
影响因子：
10.7
通讯作者：
Demiroluk, S
中科院分区：
文献类型：
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作者：
Dikmen, Y;Eminoglu, E;Demiroluk, S
本研究旨在研究插管后地氟烷对支气管平滑肌张力的影响，并将这些影响与异氟烷和七氟烷进行比较。患者随机分为三组，分别接受异氟烷（n = 22）、七氟烷（n = 23）和地氟烷（n = 22）。分别在通气开始后、吸入药物前、1 MAC（最小肺泡浓度）吸入药物通气5 min后和2 MAC吸入药物通气5 min后3个时间点记录峰值吸气压（PIP）、呼吸阻力（Rr）和动态顺应性（Cdyn）。我们发现，所有吸入剂引起的峰值吸气压（PIP）和呼吸阻力（Rr）的显着下降，并在1 MAC浓度的动态顺应性（Cdyn）的增加。当麻醉剂浓度增加到2 MAC时，地氟烷引起Rr和PIP显著增加，Cdyn降低。我们得出结论，地氟烷与异氟烷和七氟烷一样，在1 MAC浓度下表现出支气管扩张作用。然而，将浓度增加至2 MAC导致地氟烷的气道阻力增加，而七氟烷和异氟烷继续具有支气管扩张作用。
This study was designed to investigate the effects of desflurane on bronchial smooth muscle tone, following intubation and to compare these effects with isoflurane and sevoflurane. Patients were randomly divided into three groups to receive, isoflurane (n = 22), sevoflurane (n = 23), or desflurane (n = 22). Peak inspiratory pressure (PIP), respiratory resistance (Rr) and dynamic compliance (Cdyn) measurements were recorded at three time points; After the beginning of ventilation and before inhalation agent was started, following 5 min of ventilation with 1 MAC (minimum alveolar concentration) inhalation agent and following 5 min of 2 MAC inhalation agent. We found that all inhalation agents caused a significant decrease in Peak Inspiratory Pressure (PIP) and respiratory resistance (Rr), and an increase in dynamic compliance (Cdyn) at 1 MAC concentrations. When the agent concentration was increased to 2 MAC, desflurane caused a significant increase in Rr and PIP and a decrease in Cdyn. We concluded that desflurane, like isoflurane and sevoflurane, exhibits a bronchodilator effect at 1 MAC concentration. However, increasing the concentration to 2 MAC caused an increase in airway resistance with desflurane, whilst sevoflurane and isoflurane continued to have a bronchodilator effect.