艾司洛尔复合异丙酚对气管插管时循环血液动力学及儿茶酚胺的影响分析

Esmolol Combined with Propofol for Tracheal Intubation Hemodynamics and Catecholamine Impact Analysis

目的探讨艾司洛尔预防气管插管引起的血液动力学及儿茶酚胺变化的合理用量。方法将30例ASAI～II级择期手术的病人随机分成3组,A组为对照组,B组为0.5mg/kg-1艾司洛尔组,C组为0.8mg/kg-1艾司洛尔组,静注异丙酚和维库溴铵诱导气管内插管。监测插管后,1、3、5及10min收缩压(SP)、舒张压(DP)、心率(HR),并抽取血标本用高压液相色谱仪测血浆中去甲肾上腺(NE),肾上腺(CE)和多巴胺(DA)浓度。结果 A组插管后1min血压心率显著降低升高(P<0.01或0.05)。B组插管后3、5min及10min时,血压心率显著降低(P<0.01或0.05)3min及5min时去甲肾上腺及肾上腺水平显著升高(P<0.01或0.05)。C组插管后心率血压去甲肾上腺与肾上腺与水平显著降低(P<0.01或0.05)与B组比较,插管后1min和3min肾上腺素水平显著降低(P<0.01)。结论 0.8mg/kg-1艾司洛尔复合异丙酚可缓解插管时心血管反应。

Objective Of esmolol to prevent endotracheal intubation caused by changes in hemodynamics and a reasonable amount of catecholamine.Methods The 30cases of ASAI-II levels of patients undergoing elective surgery were randomly divided into 3 groups,A group for the control group,B group 0.5mg/kg-1 esmolol group,C group 0.8mg/kg-1 esmolol group,intravenous propofol and vecuronium-induced endotracheal intubation.Monitoring after intubation,1.3.5,and 10min systolic blood pressure（SP）,diastolic blood pressure（DP）,heart rate（HR）,and took blood samples using high-performance liquid chromatography measurement of plasma noradrenaline（NE）,adrenal（CE）and dopamine（DA）concentrations.Results A group of 1min after intubation significantly lower bloodpressure and heart rate increased（P0.01 or 0.05）.B group after intubation 3.5and 10 time-sharing,blood pressure,heart rate significantly lower（P0.01 or 0.05）3 and 5min when the level of noradrenaline and adrenal glands were significantly higher（P0.01 or 0.05）.C group after intubation blood pressure,heart rate,noradrenaline levels and adrenal glands and significantly lower（P0.01 or 0.05）and the B group,1min and 3 min after intubation were significantly lower epinephrine（P0.01）.Conclusion 0.8mg/kg-1esmolol combined with propofol may alleviate the cardiovascular response to intubation.