摘要
目的比较右美托咪定与艾司洛尔对气管插管心血管反应的影响。方法择期腹腔镜手术全麻患者60例,随机分为右美托咪定组(D组)、艾司洛尔组(E组)和对照组(C组)。D组诱导前10 min泵注右美托咪定0.1μg/(kg.min)(总量为1μg/kg),E组诱导前5 min给予艾司洛尔1 mg/kg,C组诱导前无药物。三组麻醉诱导均采用静脉靶控诱导设定丙泊酚效应室靶浓度5μg/L(Marsh模型)、瑞芬太尼效应室靶浓度3 ng/L(Minto模型),诱导时间设定为3 min。到达设定靶浓度时,给予罗库溴铵0.6 mg/kg,2 min后行气管插管。记录给药前(T0)、诱导前(T1)、插管前即刻(T2)、插管后即刻(T3)、插管后1min(T4)、插管后3 min(T5)各个时间段的HR,MAP,BIS值。结果组内比较:D组和E组T1-T5时的HR较T0时减慢,C组T3-T4时的HR较T0时升高(P<0.05);D组和E组T1-T5时的MAP较T0时下降,C组T3-T5时MAP较T0时升高(P<0.05)。C组T3-T4时的HR较T2时增快、T3-T5时的MAP较T2时升高(P<0.05)。组间比较:T0时,三组HR和MAP无明显差异;T1时,E组的HR较C组和D组高(P<0.05),T3-T5时C组的MAP较D组和E组高(P<0.05)。BIS值变化:T1-T5时,D组BIS值较C组和E组低(P<0.05)。结论右美托咪定和艾司洛尔均能有效抑制气管插管反应,且右美托咪定具有一定的镇静作用,能更好地维持应激时交感神经系统稳定。
Objective To compare the effect of dexmedetomidine versus esmolol on cardiovascular responses during endotracheal intubation. Methods Sixty patients scheduled for laparoscopy were randomly assigned to three groups：dexmedetomidine group,esmolol group,and control group.The patients were intravenously administrated with dexmedetomidine 0.1 μg/（kg·min） at 10 min before anesthesia induction with the total dosage of 1 μg/kg in dexmedetomidine group,esmolol 1 mg/kg in esmolol group,and no treatment in control group before anesthesia induction.All patients were inducted by target controlled infusion（TCI）,and the induction time were set to 3 min.All patients were given 5 μg/L propofol by Marsh model,and 3 ng/L remifentanil by Minto model.After reaching target concentration,0.6 mg/kg rocuronium was administrated,and trachea was intubated 2 min later.Heart rate（HR）,mean arterial pressure（MAP） and bispectral indexes（BIS） were recorded before infusion（T0）,before induction（T1）,before tracheal intubation（T2）,after tracheal intubation（T3）,and 1,3 min after tracheal intubation（T4,T5）. Results Compared with T0,HR and MAP decreased in dexmedetomidine group and esmolol group at T1-T5;while HR increased at T3-T4 in control group and MAP increased at T3-T5（P0.05）.Compared with T2,HR increased in control group at T3-T4,and MAP increased at T3-T5（P0.05）.At T0,there was no significant difference between all groups in HR and MAP.Compared with dexmedetomidine group and control group,HR was decreased at T1 in esmolol group（P0.05）.Compared with dexmedetomidine group and esmolol group,MAP was increased at T3-T5 in control group（P0.05）.At T1-T5,BIS in dexmedetomidine group was different from those in control group and esmolol group（P0.05）. Conclusion Dexmedetomidine and esmolol could effectively inhibit the stress response of endotracheal intubation.Dexmedetomidine has a certain degree of sedation,and it may be better to maintain the stability of the sympathetic nervous system t
出处
《山西医科大学学报》
CAS
2013年第7期570-572,共3页
Journal of Shanxi Medical University
