艾司洛尔对气管插管期间脑电双频指数的影响

Effects of esmolol on the bispectral index during orotracheal intubation

目的 探讨艾司洛尔对气管插管期间血流动力学和脑电双频指数(BIS)的影响。方法 30例行腹腔镜胆囊切除术的患者,随机分为2组:艾司洛尔组(试验组)和生理盐水组(对照组)。全麻诱导: 2组均靶控输注异丙酚,血浆浓度为4μg·mL-1, 维库溴铵0. 1mg·kg-1。试验组在异丙酚输注5min后,予艾司洛尔1mg·kg-1, 并以150μg·(kg·min)-1维持;对照组予生理盐水。异丙酚输注10min后,行气管插管。观察诱导前、插管前及插管后1, 3, 5min平均动脉压(MAP)、心率(HR)及BIS的变化。结果 插管后1, 3min,对照组MAP、HR显著高于诱导前,试验组与诱导前比较差异无显著性。插管后1, 3min,对照组BIS较插管前显著升高,试验组BIS与插管前比较差异无显著性。结论 气管插管时,艾司洛尔即可减轻病人的心血管反应,又可抑制插管刺激引起的大脑皮层兴奋性的增加。

Objective To assess the effect of esmolol on the hemodynamic response and bispectral index(BIS) change to orotracheal intubation. Methods Thirty patients, ASAⅠ～Ⅱ,scheduled for elective laparoscopic surgery, were randomly allocated to receive esmolol 1mg·kg -1 followed by 150 μg·(kg·min) -1 (esmolol, trial group, n=15)or saline (control group, n=15). Esmolol or saline was started 5 min after a target- controlled infusion (TCI) of propofol (blood concentration 4 μg·mL -1 ). After loss of consciousness, vecuronium 0.1 mg·kg -1 was administrated. Ten minutes after the TCI began, the trachea was intubated. BIS was recorded at 10 s intervals. Mean arterial pressure (MAP) and heart rate(HR) were measured non-invasively every min. BIS, MAP and HR were mea- sured before induction,before intubation and 1,3,5minute after intubation. Results There were no intergroup differences in BIS, HR or MAP before induction. BIS increased significantly after orotracheal intubation (compared with the pre-intubation values) in the control group only. Changes in HR and MAP with orotracheal intubation were also significantly greater in the control group than in the esmolol group. Conclusion Esmolol not only attenuated haemodynamic to orotracheal intubation, but also prevented BIS arousal reactions in patients anaesthetized with propofol.