艾司洛尔对七氟烷吸入麻醉诱导和切皮期间血流动力学和脑电双频指数的影响

Effect of Esmolol on the Haemodynamics and the Bispectral Index(BIS)during Induction of Anaesthesia and Skin Incision with Sevoflurane Inhalation

目的观察艾司洛尔对七氟烷吸入麻醉诱导和切皮期间血流动力学和脑电双频指数(BIS)的影响。方法选择ASAⅠ～Ⅱ级择期骨科手术患者80例,随机分为4组:七氟烷组即对照组(S组,20例),采用面罩吸入6%七氟烷诱导气管插管;芬太尼组(F组,20例),2μg/kg;艾司洛尔组(E组),先1mg/kg,并以50μg.kg-1.min-(1E1,20例)或100μg.kg-1.min-(1E2,20例)速度维持。观察诱导前、后,插管前及后1、3、5min,切皮前及后3min收缩压(SBP),心率(HR)和BIS值变化。结果插管后1minS组,F组和E1组SBP,HR明显升高,E2组没有明显变化。插管后1,3minF组,E1组,E2组SBP均低于S组(P<0.01)。插管后1,3minE1和E2组HR和BIS明显低于S组(P<0.01)。切皮后各组SBP、HR和BIS没有明显变化。结论艾司洛尔1mg/kg后给予100μg.kg-.1min-1维持输注可稳定七氟烷吸入诱导期间血流动力学和BIS增加。

Objective To study the effect of esmolol on the haemodynamics and the bispectral index （ BIS ） during induction of anaesthesia and skin incision with sevoflurane inhalation. Methods Eighty Ⅰ -Ⅱ ASA patients aged 20-60 yrs weighing 55-82 kg were enrolled and underwent elective surgery of general anesthesia. The patients were randomly divided into four groups： sevoflurane group （S, n =20）,in which anaesthesia was inducted in four groups with 6% sevoflurane via a face mask and incubated; fentanly group （F,n =20）,2μg/kg; esmolol group （El and E2,n = 20 each ）,a bolus of esmolol 1 mg/kg,followed by an infusion of 50μg ·kg^-1/min and 100 μg ·kg^-1/min before induction. SBP blood pressure, heart rate, BIS were recorded at baseline, and 1.3 MAC of sevoflurane, incubation, 1,3,5 min after incubation,and before and 3min ＇after skin incision. Results SBP,HR and BIS were significantly increased lmin after incubation in group S, group F and group El ,as compared with baseline （P 〈 0.01 ）,but there were no changes in group E2. SBP was significantly decreased land 3min after incubation in group F,E1 and E2,as compared with group S （P 〈 0.01 ）. HR and BIS were significantly decreased land 3min after incubation in group E1 and E2,as compared with group S （P 〈 0.01 ）. SBP,HR and BIS had no significant changes after skin incision. Conclusion Esmolol can significantly inhibit the changes of the haemodynamics and BIS during induction of anaesthesia and skin incision with a bolus of esmoM 1 mg/kg, which is followed by an infusion of 100μg·kg^-1·min^-1 before induction.