超声心动图监测依托咪酯在全麻诱导期对血流动力学的影响

Effect of etomidate on hemodynamics monitored by ultrasonic cardiography during anesthesia induction

目的用超声心动图来监测依托咪酯乳剂（商品名：宜妥利）在全麻诱导期对血流动力学的影响。方法选择全麻患者60例，随机分为A组（依托咪酯乳剂组）、B组（异丙酚组）和C组（依托咪酯乳剂＋异丙酚组），每组20例，在全麻诱导时，A组静注依托咪酯乳剂0．3mg／kg，B组静注异丙酚1．6mg／kg，C组静注依托咪酯乳剂0．15mg／kg＋异丙酚0．8mg／kg。经体表用超声多普勒诊断仪监测期间的血流动力学变化，记录：诱导前期（T0），诱导后插管前（T1），捅管即刻（T2），插管后1min（T3），插管后5min（T4）的血流动力学变化。结果C组在全麻诱导期对血流动力学影响较其他两组更为稳定。结论在全麻诱导插管期间，联合应用依托咪酯（宜妥利）加异丙酚可使患者的血流动力学更加稳定。

Objective Perioperative echocardiography and right ventricular volumic monitoring were used for more es- sential evaluation of different hypnotics in surgical patients. Ultrasonic cardiography was applied to monitor the effect of etomidate and diprivan on hemodynamics during anesthesia induction. Methods 60 elderly patients are selected and divided into A, B and C groups with 20 cases in each group. During anesthesia induction, the patients were administered with etomidate 1.6 mg/kg in the A group, with diprivan 1.6 mg/kg in the B group and with etomidate 0.15mg/kg＋diprivan 0.12 mg/kg in the C group, respectively. Patients of all groups were administered with sulfentanyl 0.2 ug/kg, midazolam 0.06 mg/kgand0.12mg/kg. Hemodynamics figures in duration of pre-induction （A0）, post-inductionandpre-intubation （A1）, intubation （A2） and post-intube lmin （A3） were recorded, respectively. Result The patientsintheCgroup （etomidate＋ propof） appeared more stable in hemodynamics compared with the other two groups. Conclusion Combination of etomidate plus diprivan leads to more stable hemodynamics during anesthesia induction.