术前口服倍他乐克对于麻醉诱导丙泊酚的用量和血流动力学的影响

Effect of Premedication of Oral Betaloc on Propofol Requirements and Hemodynamic Changes during Anesthesia Induction

【目的】本研究探讨术前口服倍他乐克对麻醉诱导时丙泊酚的用量和血流动力学变化的影响。【方法】选择择期手术的全麻病人(ASAⅠ～Ⅱ)60例,随机分成两组,每组30例,第一组为实验组(B组),术前口服倍他乐克50mg,第二组为对照组(C组)给予安慰剂;以30mg﹒kg-1﹒h-1的恒速灌注丙泊酚至BIS达到50,记录病人入睡时和BIS=50时丙泊酚的用量以及插管前后血压、心率、中心静脉压和心输出量变化。【结果】两组病人入睡时丙泊酚的用量:B组是(1.35±0.22)mg﹒kg-1;C组是(1.60±0.24)mg﹒kg-1,组间差异P<0.01;BIS=50时的丙泊酚的用量:B组是(1.71±0.27)mg﹒kg-1;C组是(1.98±0.24)mg﹒kg-1;组间差异P<0.01;B组插管前、后血压和心率的变化程度较C组小(P<0.05),插管过程中心静脉压和心输出量组间变化差异不大。【结论】术前口服倍他乐克50mg减少麻醉诱导丙泊酚的用量,插管时的血流动力学相对稳定。

[Objective] To evaluate the influence of premedication of oral betaloc on propofol requirements and hemodynamic changes for anesthesia induction. [Methods] Sixty patients [ASA （American Society of Anesthesiologists） Ⅰ-Ⅱ ] undergoing selective operation were randomly assigned into 2 groups （group B and group C）. Patients in group B received a premedication of oral betaloc 50 mg and group C received placebo. Anaesthesia was induced with propofol at the rate of 30 mg·kg^-1· h^-1 to achieve the loss of patients＇ consciousness, and continued infusing propofol until the bispectral index scale （BIS） reached 50. Propofol requirements of the patients losing consciousness and the BIS reaching 50 were recorded. Blood pressure （BP）, heart rate （HR）, central venous press （CVP） and cardiac output （CO） during the anesthesia were recorded. [ Results ] There were significant differences of propofol requirements of the patients losing consciousness （group B was （1.35±0.22） mg·kg^-1and group C was （1.60±0.24） mg·kg^-1 and BIS reaching 50 （group B was （1.71±0.27） mg·kg^-1 and group C was （1.98±0.24） mg·kg^-1 P 〈 0.01. Change magnitude of mean blood pressure （MBP） and heart rate （HR） between preintubation and postintubation in group B was significantly less than that in group C. Change magnitude of CVP and CO between groups during intubation were not significant difference. [ Conclusion ] Premedication of oral betaloc 50 mg reduces the propofol requirements, and provide stable cardiovascular state during propofol induction.