摘要
目的观察艾司洛尔对缺血性心脏病患者全身麻醉期间氧代谢的影响。方法30例有缺血性心脏病史择期行上腹部手术患者,随机分为对照组(组I,生理盐水)、小剂量艾司洛尔组(组II,50μg·kg-1·min-1)、中剂量艾司洛尔组(组III,100μg·kg-1·min-1)。采用咪唑安定—芬太尼—维库溴铵—丙泊酚麻醉。手术开始后输注艾司洛尔或生理盐水,在开始用药时(T0)、用药后10(T1)、30(T2)、60(T3)、90(T4)min测定心率(HR)、平均血压(MAP)、心指数(CI)、CO2分钟生成量(V·CO2),同步抽取桡动脉血和右心房或右心室血行血气分析,并计算氧耗量(V·O2)。结果在T0、T1、T2点,组II、组III与组I比较,组间HR、MAP、CI、MCO2、VO2无显著差异(P>0.05)。在T3、T4点,组I的CI、V·O2、V·CO2显著上升,而组II、组III无明显增加,组间差异显著(P<0.01)。结论持续应用小剂量和中剂量艾司洛尔,可减轻全身麻醉下缺血性心脏病患者手术后期氧耗的增加,并改善血流动力学。
Objective To evaluate the influence of esmolol on oxygen metabolism during general anesthesia in ischemic heart disease patients. Methods Thirty patients with ischemic heart disease scheduled for abdominal surgery were randomly divided into three groups : control group (group I, saline), low-dose esmolol group (group II,50 μg·kg -1·min -1) and middle-dose esmolol group (group III, 100 μg·kg -1·min -1). Under midazolam-fentanyl-vecuru- nium-propofol anesthesia, the HR, MAP, cardiac index (CI 2),minute CO 2 production (V·CO 2),oxygen consumption (V·O 2) were recorded at 0(T 0), 10(T 1),30(T 2),60(T 3),90(T 4) min after esmolol or saline infusion during anesthesia. Results No intergroup differences in HR,MAP,V·CO 2, V·O 2 were found at T 0, T 1 and T 2. The HR was less in group II and group III than in group I at T 3 and T 4. The CI,V·CO 2 and V·O 2 were significantly increased at T 3 and T 4 than those at T 0 in group I, but not in group II and group III. The CI,V·CO 2 and V·O 2 were significantly greater in group I than those in group II and group III at T 3 and T 4 (P<0.01). Conclusion Low to middle dose esmolol significantly decreased oxygen consumption in patients with ischemic heart disease during abdominal surgery.
出处
《上海第二医科大学学报》
CSCD
北大核心
2005年第6期600-602,共3页
Acta Universitatis Medicinalis Secondae Shanghai
