丙泊酚及咪唑安定对心内传导系统的影响

Effects of propofol and midazolam on heart conduction system

目的比较丙泊酚及咪唑安定对人体心内传导系统的影响。方法病人20例,随机均分为两组:A组,丙泊酚2 mg/kg诱导,4 mg.kg-1.h-1持续泵注;B组,咪唑安定0.15 mg/kg,1 min内注入。分别在麻醉前、后测定HR、窦房传导时间(SACT)、最大窦房结恢复时间(SNRTMAX)、矫正窦房结恢复时间(CSNRT)、窦房结恢复时间指数(SNRTI)、文氏型A-V传导频率(WB)、P-R间期、QRS波。结果两组患者均使SACT明显延长(P<0.01和P<0.05),A组,WB明显提前(P<0.05),其他参数无明显改变。结论丙泊酚和咪唑安定对窦房结传导均有抑制作用,丙泊酚2 mg/kg静注后还能抑制房室交界区传导。有窦房传导阻滞疾患的病人,丙泊酚和咪唑安定均应谨慎使用。

Objective To investigate the effects of propofol and midazolam on heart conduction system. Methods Twenty patients were randomly divided into two groups with 10 cases each. In group A, propofol 2 mg/kg was injected for anesthesia induction, and 4 mg · kg^- 1 · h^-1 infused con tinuously for maintenance. In group B, midazolam 0. 15 mg/kg was injected. HR, sinus atrial conductive time（SACT）, maximum sinus node recovery time（SNRTMAX）, correct sinus node recovery time （CSNRT）, correct sinus node recovery time index（SNRTI）, WB, P-R interval and ORS wave recorded before anesthesia, at 1 min after propofol injection and 3 min after midazolam injection. Results SACT was significantly lengthened after drug administration compared with that before in two groups, and 2 mg/kg of propofol markedly decreased the WB. The other criteria were not signifi cantly changed in both groups. Conclusion Propofol and midazolam have a pronounced depressive effect on the heart conduction system.