摘要目的 评价不同浓度地氟醚对女性患者心脏电生理稳定性的影响.方法 择期女性全麻患者40例,ASA分级Ⅰ或Ⅱ级,年龄20～50岁,体重45 ～ 77 kg.采用随机数字表法分为2组(n=20):0.6 MAC组(D1组)和1.3 MAC组(D2组).入室开放静脉通路,静脉注射咪达唑仑0.1mg/kg、维库溴铵0.1 mg/kg、芬太尼3μg/kg和依托咪酯0.3 mg/kg,气管插管术后行机械通气.使D1组和D2组地氟醚浓度分别达到0.6和1.3 MAC.于麻醉诱导前(T1)、气管插管后5 min(T2)和达地氟醚设定浓度后20 min(T3)时采集12导联心电图,测量QT间期、Tp-e间期,计算QTc间期、Tp-e/QT比值和心脏电生理平衡指数(iCEB),观察心律失常的发生情况.结果 与T1.2时比较,2组T3时QT间期和QTc间期延长,Tp-e/QT比值降低(P＜0.05);2组各时点QT间期、Tp-e/QT比值和iCEB比较差异无统计学意义(P＞0.05).2组均未发生心律失常.结论 临床浓度地氟醚在一定程度上影响女性患者心脏电生理稳定性,但均未发生心律失常.

abstractsObjective To evaluate the effects of different concentrations of desflurane on the electrophysiological stability of hearts in female patients.Methods Forty female patients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 20-50 yr,weighing 45-77 kg,scheduled for elective surgery with general anesthesia,were divided into 2 groups (n =20 each) using a random number table method:0.6 MAC group (group D1) and 1.3 MAC group (group D2).The intravenous access was opened after admission to the operating room,midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 3 μg/kg and etomidate 0.3 mg/kg were injected intravenously,and mechanical ventilation was performed after tracheal intubation.The concentrations of desflurane reached 0.6 and 1.3 MAC in D1 and D2 groups,respectively.Twelve-lead electrocardiograms were collected before anesthesia induction (T1),at 5 min after intubation (T2) and at 20 min after reaching the set concentration of desflurane (T3).The QT interval and Tpe interval were measured,the QTc interval,Tp-e/QT ratio and index of cardiac electrophysiological balance were calculated,and the development of arrhythmia was also observed.Results The QT interval and QTc interval were significantly longer,and the Tp-e/QT ratio was lower at T3 than at T1,2 in two groups (P＜ 0.05).There was no significant difference in QT interval,Tp-e/QT ratio or index of cardiac electrophysiological balance at each time point between two groups (P＞0.05).No arrhythmia was found in neither group.Conclusion The clinical concentration of desflurane affects the electrophysiological stability of hearts to some extent in female patients without causing arrhythmia.