艾司洛尔对冠脉搭桥患者气管插管的影响

Effect of Esmolol on the Hemodynamics Response to Tracheal Intubation Inpatients Undergoing CABG

目的:研究艾司洛尔对冠心痛患者气管插管反应的影响。方法:选择冠脉搭桥患者60例,随机分为3组,Ⅰ组为对照组;Ⅱ组为插管前5 min给艾司洛尔(1．5 mg／kg)组;Ⅲ组为插管前即刻给艾司洛尔(1．5 mg／kg)组。在诱导前,诱导后,插管后即刻,插管后2 min、5 min、10 min分别监测血压、心率、血氧饱和度、肺动脉压、肺循环阻力、体循环阻力等。结果:3组患者在麻醉诱导后血压、心率都下降(P<0．01),而肺血流动力学变化不明显。对照组在气管插管后血压和心率明显升高(P<0．01),而用艾司洛尔的两组血压和心率也升高,但无统计学差异。其中Ⅲ组在插管后5 min,10 min心率较慢,其中有2例心率为<40 bpm,但血流动力学较稳定,未作处理;而Ⅱ组插管后血压、心率与诱导后无显著差异。插管后,对照组与艾司洛尔两组相比,血压和心率变化较大,有显著差异(P<0．05);而肺血流动力学变化不明显。对照组有4例出现室性早搏,而艾司洛尔组无室性心律失常发生。结论:结论艾司洛尔能有效地、安全地抑制冠心病患者由麻醉气管插管引起的心血管反应,诱导前5 min给药更好。

Objective：The effect of esmolol on the hemodynamicsresponse to tracheal intubation in patients undergoing CAIn. Methods：Sixty patients scheduled for CABG were dividedramdomly into 3 groups： （Ⅰ） controlled; （Ⅱ） those receivingesmolol 5min before tracheal intubation; （Ⅲ） those receivingesmolol before tracheal intubation. The systemic and I pulmonaryhemodynamic were monitored. Results： The MAP, HR significantlydecreased after induction of anesthesia in all groups（P〈0.01 ） ,pul monary hemodynamics were no statistical changed. The MAP, HR significantly increased after tracheal intubation in group Ⅰ （P〈0. 01） ,The MAP, HR increased in group Ⅱ and Ⅲ,but nostatistical differences（P〉0. 05）. Compared with group Ⅰ工. and Ⅲ,theMAP, HR significantly increased in group I（P〈0. （15）. There were 4patients with ventricular arrhythmias in group Ⅰ. Conclusion .. Esmolol have a considerable effect on hemodynamics response totracheal intubation in patients undergoing CABG.