摘要
目的观察倍他乐克用于老年高血压患者在非心脏手术麻醉诱导前后血压、心率的变化,探讨其降低血压、减慢心率与保护心肌的作用。方法选择60例ASAⅠ～Ⅲ级择期全麻非心脏外科手术的老年高血压患者,随机分为试验组(Ⅰ组)和对照组(Ⅱ组),每组30例,在麻醉诱导前Ⅰ组予以倍他乐克40μg/kg,Ⅱ组予以生理盐水2ml,采用异氟醚复合芬太尼维持麻醉。观察麻醉诱导前(T0),插管即刻(T1),插管后1min(T2),3min(T3),5min(T4),10min(T5),1h(T6),术毕(T7)各时点的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、RPP(心率×收缩压)的变化及使用麻黄素、阿托品的例数。结果两组患者的一般资料无显著性差异(P>0.05)。与T0比较,Ⅰ组T1～T7SBP、DBP、MAP、HR、RPP显著降低(P<0.05),Ⅱ组在T1～T5时SBP、DBP、MAP、HR、RPP显著升高(P<0.05),T5～T7趋于平稳。与Ⅱ组比较,Ⅰ组在T1～T7各时点SBP、DBP、MAP、HR、RPP有显著差异(P<0.05),但两组使用麻黄素、阿托品的例数无差异(P>0.05)。结论倍他乐克能有效地降低血压,减慢心率,降低心肌氧耗,抑制全麻诱导气管插管所致的心血管反应,易于维持稳定的循环功能,能够安全应用于老年高血压患者围术期。
Objective To evaluate hemodynamic changes and the protective effect of Betaloc on myocardium in elderly hypertension patients undergoing noncardiac surgery. Methods Sixty elderly hypertension patients who were evaluated to ASA Ⅰ - Ⅲ scheduled for noncardiac：surgery were randomly divided into experimental group （ group Ⅰ , n = 30}, induction Betaloc 40μg/kg; and controlled group （group Ⅱ , n = 30）, no Betaloc. The data of systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean arterial blood pressure （ MAP）, heart rate （ HR ） and RPP （ HR × SBP ） were measured at following occasion ： before induction （ T0 ）, intubation （ T1 ）, and 1 min （T2 ） , 3min （ T3 } , 5min （ T4 ）, 10min （ T5 ）, 1 h （ T6 ） after intubation, and the end of operation （ T7）. All of the patients were maintained the general anesthesia with isofluence and fentynle. Ephedrine and atropine used during operation were recored. Results There were no significant difference at baseline data between two groups （P 〉 0.05 ）. Compared with controlled group, intravenous Betaloc could more reduce cardiovascular reaction, heamodynamics be more stable in the experimental group during intubation and operation （ P 〈 0.05 ）. There were no significant difference at incidence of side- effects events between two groups （ P 〉 0.05 ）. Conclusion Betaloc can inhibit the cardiovascular reaction during intubation of general anesthesia, reduce the usage of fentyule, and can also protect myocardium of elderly hypertension patients undergoing noncardiac surgery.
出处
《四川医学》
CAS
2005年第8期832-834,共3页
Sichuan Medical Journal
关键词
高血压
麻醉
倍他乐克
hypertension
anesthesia
betaloc
