异丙酚及咪唑安定诱导对心脏瓣膜置换术患者血液动力学的影响

Comparison of effects of propofol and midazolam on hemodynamics during induction in patients undergoing cardiacvaive replacement

目的:比较异丙酚和咪唑安定对心脏瓣膜置换术患者在诱导前后对血液动力学的影响。方法:20例ASA Ⅱ～Ⅱ级,成年患者随机分成2组,分别静注异丙酚2mg/kg(P组)或咪唑安定0.2mg/kg(M组)诱导。局麻下插Swan-Ganz导管到肺动脉,分别在诱导前,注药后2、5、10分钟时测血液动力学变化。结果,P组SP、DP、MAP、CO在诱导后2分钟即显著下降(P<0.05),M组SP、DP、MAP和CO在10分钟时才显著下降(P<0.05),P组对MPAP、LVSW、RVSW、PAWP、SVRI无明显影响,M组明显降低MPAP、RVSW(P<0.05),对PAWP、LVSW、SVRI无明显影响。结论:两药均可安全地用于心脏瓣膜置换术患者的诱导。

Objective: To compare the hemodynamic effects of propofol and midazolam during induction in patients scheduled for cardiac valve replacement. Method: Twenty patients were randomly allocated to receiving intravenous propofol 2mg/kg(group P) or midazolam 0.2mg/kg(group M) respectively,7F Swan-Ganz catheter was inserted into the pulmonary artery via the right internal jugular vein, CO was measured with the thermodilution method. All hemodynamic data were recorded before administration and 2,5,10 min after the administration. Result:Two min after the propofol administration,SP、DP、MAP and CO decreased significantly(P<0.05),while significant changes were observed 10 min after the injection of midazolam. In group P,MPAP, LVSW and RVSW changed unsignificantly,in group M,MPAP and RVSW decreased markedly, PAWP,LVSW and SVRI remained stable. Conclusion:Propofol and midazolam may be administrated safely for patients undergoing cardiac valve replacement.