预注羟乙基淀粉130/0.4对老年病人异丙酚麻醉诱导时血流动力学的影响

Effect of Priming Hydroxyethyl Starch 130/0.4 on Hemodynamics in Elderly Patients during Anesthetic Induction with Propofol.

目的:观察麻醉前预注羟乙基淀粉130/0.4对老年病人异丙酚麻醉诱导时血流动力学的影响。方法:选择60例ASA I^II级老年择期手术患者,随机分成两组。观察组于麻醉前30分钟输注羟乙基淀粉130/0.4 500ml,对照组输注乳酸林格氏液500ml。记录两组患者麻醉前(T1)、麻醉后5min(T2)、10min(T3)、及20min(T4)时收缩压(SBP)、舒张压(DBP)及心率(HR)的变化。结果:与T1比较,对照组T2、T3及T4时SBP、DBP及HR均明显下降(P<0.001),而观察组仅T2时SBP、DBP及HR下降明显(P<0.001)。组间比较,T2、T3及T4时,对照组SBP、DBP及HR较观察组明显下降(P<0.001)。结论:输入足量HES130/0.4扩容可有效预防老年患者异丙酚和瑞芬太尼麻醉诱导时的低血压。

Objective： To investigate the effect of priming hydroxyethyl starch 130/0.4 （HES130/0.4） on hemodynamics in eldly patient during anesthetic induction with propnfol. Methods： Sixty elderly patients, physical status Ⅰ-Ⅱ, undergoing elective surgery were randomly divided into two groups. Hydroxyethyl starch 130/0.4 was infused in observation group 30 min before anesthesia and Laeted Ringer＇s solution in control group. SBP, DBP and HR were recorded before anesthesia （T1 ） , 5min （T2）, 10min （T3） and 20min （T4） after anesthesia. Results ： SBP, DBP and HR were significantly decreased at T2, T3 and T4 in control group （ P 〈 0.001 ）, but at T2 in observation group （ P 〈 0.001 ） compared with those at TI. SBP, DBP and HR were signifieandy decreased at T2, T3 and T4 in control group compared with those in observation group （ P 〈 0.001 ） . Conclusion： Priming infusion of HES130/0.4 could effectively prevent hypotension in elderly patients during anesthetic induction with propofol and remifentanil.