艾司洛尔预防气腹后心血管反应的临床观察

Effects of esmolol on haemodynamic response to CO2 pneumoperitoneum for laparoscopic cholestectomy

目的观察艾司洛尔在腹腔镜手术中对气腹引起的心血管反应的作用。方法选择择期行腹腔镜胆囊切除术患者60例,随机分为对照组和观察组各30例,两组均行气管插管静吸复合全麻,术中用七氟烷和瑞芬太尼维持麻醉,观察组诱导前静注艾司洛尔0.5 mg/kg,术中以10μg/(kg.m in)维持,对照组使用生理盐水。结果对照组插管时和气腹后血压、心率均明显升高,而观察组无明显变化,两组比较差异显著。结论艾司洛尔能预防插管和气腹引起的心血管反应,使腹腔镜手术循环更加平稳。

Objective To evaluate the effects of esmolol on haemodynamic response to C02 pneumoperitoneum for laparoscopic cholestectomy. Methods 60 patients undergoing laparoscopic cholestectomy were randomly divided into study group（ n = 30） and control group（ n = 30 ）, receiving intravenous esmolol[0.5 mg/kg bonus and 10 ug/（ kg ·min） maintenance] or physiological saline before anesthesia induction. Isoflurane and fentanil were used to maintain anesthesia in intravenous inhalational anesthesia. Results Compared with study group, the MAP and HR at T2 and T3 in control group was significantly higher（ P 〈 0.05 ）. Conclusion Esmolol blunts the pressor response to intubation and pneumoperitoneum, and provides more stable haemodynamics for laparoscopic cholestectomy.