摘要
目的观察奈福泮对老年患者丙泊酚诱导期低血压发生率及血浆儿茶酚胺浓度的影响。方法选择择期行食管癌手术老年患者60例,随机分为奈福泮组(N组)和对照组(C组)。丙泊酚诱导后,N组静注奈福泮0.25 mg/kg,C组静注等容生理盐水。记录诱导前(T_0)、诱导后2 min(T_1)、气管插管成功即刻(T_3)、气管插管成功后1 min(T_4)时心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、低血压(MAP下降>30%基础值)发生率及心动过缓(HR<50次/min)发生率。T0和气管插管前(T_2)检测血浆儿茶酚胺浓度。结果 N组无低血压发生,心动过缓发生率为3.33%,显著低于C组的低血压发生率(20%)和心动过缓发生率(26.7%)(P<0.05)。N组血浆去甲肾上腺素水平为(321±97)pg/m L,显著高于C组(238±70)pg/m L(P<0.05);2组间血浆多巴胺及肾上腺素水平差异无统计学意义。结论奈福泮可减少丙泊酚诱导期低血压及心动过缓发生率,升高血浆去甲肾上腺素浓度。
Objective To observe the effect of nefopam on incidence rate of hypotension and plasma catecholamine concentration in elderly patients in propofol induction period.Methods Sixty elderly patients underwent scheduled esophageal cancer surgery were randomly divided into nefopam group （group N） and control group （group C）.After propofol induction,patients in group N received 0.25 mg/kg nefopam,and group C was given the same volume of saline.Heart rate （HR）,mean arterial pressure （MAP） and central venous pressure （CVP） as well as incidence rates of hypotension （MAP decreased ＞30％ of the baseline value） and bradycardia （HR ＜ 50 beats per minute） before induction （T0）,2 min after induction （T1）,immediately after successful endotracheal intubation （T3） and 1 min after successful endotracheal intubation （T4） were recorded.Venous blood was drawn to determine the plasma catecholamine concentration at T0 and just before endotracheal intubation （T2）.Results No hypotension was observed in group N,and the incidence rate of bradycardia was 3.33％,which were significantly lower than 20％ and 26.7％ in the group C （P ＜0.05）.The plasma noradrenaline concentration was significantly higher in the group N than the group C （P ＜0.05）.The plasma concentrations of dopamine and adrenaline showed no significant difference between the two groups.Conclusion Nefopam can reduce the incidence rates of propofol-induced hypotension and bradycardia,and increase the plasma noradrenaline concentration.
作者
李永军
齐敦益
LI Yongjun;QI Dunyi(Xuzhou Medical University,Xuzhou,Jiangsu,221004)
出处
《实用临床医药杂志》
CAS
2018年第11期19-22,共4页
Journal of Clinical Medicine in Practice
