Hemodynamic Evaluation of Anesthetics and Positioning by Transesophageal Echocardiography

通过经食管超声心动图评估麻醉和定位的血流动力学

• 批准号: 07671690
• 负责人: TOYOTA Shigeyoshi
• 金额: $ 1.34万
• 依托单位: Jikei University School of Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671690/
• 关键词: Transesophageal Echocardiography; Anesthesia; Muscle Relaxant; Positioning; Cardiovascular System; Coronary Sinus; Coronary Artery Bypass Grafting; 腹臥位; パンクロニウム; ベクロニウム

After obtaining informed consent from each patient, we studied as follows.1.We evaluated effect of pancuronium bromide (PB) and vecuronium bromide (VB) on the left ventricular function of surgical patients using the transesophageal echocardiography (TEE). PB caused significant increases in Heart rate (HR), blood Pressure (BP) and cardiac index (CI). The enhanced HR probably caused the increase in CI,because there was no singificant increase in stroke volume index (SVI).PB had no effect on left ventricular systolic functions. VB didn't cause any significant changes in hemodynamic performance.2.We investigated effect of prone positioning on cardiac function using TEE.In the prone position, there was significant reduction in left ventricular volume (LVV), diminishment of systolic pulmonary venous flow velocity (PVFV) and pulmonary venous velocity time integral (PVVTI) and enhancement of diastolic PVFV and PVVTI.SVI and CI did not change significantly in the prone position. These changes were probably due to a decrease in the venous return due to inferior vena caval compression, and decreased left ventricular compliance due to increased intra-thoracic pressure in the prone position.3.We performed this study to estimate changes in coronary sinus flow (CSF) during coronary artery bypass grafting (CABG) by TEE.All velocities and VTI of CSF increased significantly after CABG,which was probably due to increased coronary blood flow after CABG.The results of this study indicate the feasibility of this new perioperative method of CABG evaluation.

在获得患者知情同意后，我们进行了以下研究：1.应用经食管超声心动图（TEE）评价潘库溴铵（PB）和维库溴铵（VB）对手术患者左心功能的影响。PB引起心率（HR）、血压（BP）和心脏指数（CI）显著增加。心搏量指数（SVI）无明显增加，提示心率增加可能引起CI增加，PB对左室收缩功能无影响。VB对血流动力学无明显影响。2.通过TEE研究俯卧位对心功能的影响，俯卧位时左心室容积（LVV）明显减少，收缩期肺静脉流速（PVFV）和肺静脉流速时间积分（PVVTI）降低舒张期PVFV、PVVTI增强，SVI、CI在俯卧位时无明显变化。这些变化可能是由于下腔静脉受压导致静脉回流减少，以及俯卧位胸内压升高导致左心室顺应性降低所致。3.应用TEE评价冠状动脉旁路移植术（CABG）期间冠状静脉窦血流（CSF）的变化。结果表明，这一新的冠状动脉旁路移植术围手术期评估方法是可行的。

项目成果

S.Toyota et al: "Hemodyamic Evaluation of the Prone Position by Transesophageal Echocardiography." Journal of Clinical Anesthesia. (In Press).

S.Toyota 等人：“通过经食管超声心动图对俯卧位进行血流动力学评估”。

S.Toyota,et al: "Hemodynamic Evaluation of Pancuronium and Vecuronium by Transesophageal Echoardiography" Journal of Anesthesia. (発表予定).

S. Toyota 等人：“经食管超声心动图对泮库溴铵和维库溴铵的血流动力学评估”麻醉杂志（待出版）。

S.Toyota, et al.: "Hemodynamic Evaluation of Pancuronium and Vecuronium by Transesophageal Echoardiography" Journal of Anesthesia. 11. 167-169 (1997)

S.Toyota 等人：“通过经食管超声心动图对泮库溴铵和维库溴铵进行血流动力学评估”麻醉杂志。

S.Toyota, et al: "Hemodynamic Evaluation of the Prone Position by Transesophageal Echoardiography" Journal of Clinical Anesthesia. (印刷中).

S. Toyota 等人：“经食管超声心动图对俯卧位的血流动力学评估”《临床麻醉杂志》（正在出版）。

S.Toyota et al.: "Hemodynamic Evaluation of Pancuronium and Vecuronium by Transesophageal Echocardiography." Journal of Anesthesia. 11. 167-169 (1997)

S.Toyota 等人：“通过经食管超声心动图评估泮库溴铵和维库溴铵的血流动力学。”