摘要
目的:探讨依托咪酯对小儿先天性心脏病手术麻醉应激反应及血流动力学的影响。方法:选取2016年1月至2018年1月盐城市第一人民医院收治的拟行介入手术治疗的先天性心脏病患儿100例,采用随机数字表法分为观察组和对照组,每组50例。观察组患儿给予依托咪酯麻醉诱导,对照组患儿给予丙泊酚麻醉诱导。对比两组患儿的镇静效果、Ramsay评分及面部表情疼痛量表(faces pain scale,FPS)评分的差异,观察两组患儿麻醉前(T0)、麻醉诱导1min(T1)、麻醉诱导2min(T2)、麻醉诱导3min(T3)及插管3min(T4)时的血流动力学指标水平。结果:观察组患儿停药后苏醒时间为(6.12±1.05)min,明显短于对照组的(11.76±2.14)min,差异有统计学意义(P<0.05)。观察组患儿的Ramsay评分、FPS评分明显优于对照组,差异均有统计学意义(P<0.05)。T1、T2及T3时,观察组患儿的收缩压、舒张压、平均动脉压及心率乘积水平明显高于对照组,差异均有统计学意义(P<0.05)。结论:对于行介入手术治疗的先天性心脏病患儿,采用依托咪酯麻醉诱导的镇静、镇痛效果更好,且对患儿的血流动力学指标影响较小。
OBJECTIVE: To probe into the effects of etomidate on anesthetic stress response and hemodynamics in surgery for congenital heart disease in infants. METHODS: 100 infants with congenital heart disease undergoing surgery admitted into Yancheng City No.1 People’s Hospital from Jan. 2016 to Jan. 2108 were selected and divided into observation group and control group via random number table, with 50 cases in each group. The observation group was given etomidate for anesthesia induction, while the control group was given propofol. Differences in sedative effect, Ramsay score and faces pain scales(FPS) score between two groups were compared. The hemodynamic indices before anesthesia(T0), 1 min after anesthesia induction(T1), 2 min after anesthesia induction(T2), 3 min after anesthesia induction(T3), and 3 min after intubation(T4) were observed. RESULTS: The wake-up time after drug withdrawal of observation group was(6.12±1.05) min, which was significantly shorter than that of the control group [(11.76±2.14) min], with statistically significant difference(P<0.05). The Ramsay score and FPS score of observation group were significantly better than those of the control group, with statistically significant difference(P<0.05). At T1, T2 and T3, the SBP, DBP, MAP and RPP levels of observation group were significantly higher than those of the control group, with statistically significant difference(P<0.05). CONCLUSIONS: The application of etomidate in surgery for congenital heart disease in infants has better sedative and analgesic effects, which has less effects on hemodynamic indices.
作者
邱海艳
孙亚玲
钱斌
QIU Haiyan;SUN Yaling;QIAN Bin(Dept.of Anesthesiology,Yancheng City No.1 People’s Hospital,Jiangsu Yancheng 224000,China)
出处
《中国医院用药评价与分析》
2019年第6期711-712,716,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
先天性心脏病
依托咪酯
麻醉诱导
血流动力学
Congenital heart disease
Etomidate
Anesthesia induction
Hemodynamics
