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目的 用心率变异性分析探讨地氟醚交感兴奋作用的发生机制。方法 择期手术病人30例(ASAⅠ～Ⅱ),随机分为地氟醚(15例)、异氟醚(15例)两组。不用术前药。气管插管后观察不同MAC时地氟醚和异氟醚对MAP、HR和心率变异性(HRV)的影响。结果 心率变异TP、HF和LF二组均逐渐降低,而在15MAC时地氟醚组HF明显降低、LF/HF明显升高。结论 地氟醚的交感兴奋作用机制是其抑制迷走神经胜过对交感神经的抑制,影响交感和副交感的均衡性,而显示出交感兴奋作用。
Objective To investigate the mechanism of sympathetic excitability of desflurane in heart rate variability analysis. Methods Thirty patients (ASA Ⅰ ~ Ⅱ) undergoing elective surgery were randomly divided into two groups: desflurane (15 cases) and isoflurane (15 cases). No preoperative medicine. The effects of desflurane and isoflurane on MAP, HR and heart rate variability (HRV) were observed after tracheal intubation. Results Heart rate variability decreased gradually in both TP, HF and LF groups, but HF decreased significantly and LF / HF increased significantly at 15MAC in desflurane group. Conclusion The mechanism of sympathetic excitability of desflurane is that it inhibits the vagus nerve from over inhibiting the sympathetic nerve, affecting the balance of sympathetic and parasympathetic, and showing sympathetic excitement.