尼卡地平预防气管插管时心血管反应的研究

Effects of Nicardipine on Circulatory Response to Tracheal Intubation

目的和方法 :为了解尼卡地平预防气管插管心血管反应 ,将 3 8例病人随机分为治疗组 (n =2 0 )和对照组(n =18)。诱导前 5分钟治疗组静注尼卡地平 15 μg/kg ,对照组静注生理盐水 5ml。诱导药为依托咪酯 0 3mg/kg、芬太尼 5 μg/kg和琥珀胆碱 1 5mg/kg。结果 :治疗组插管后血压无明显增高 ,但心率仍有一过性增快。静注尼卡地平后CO增加 ,但两组病人在诱导和插管过程中CO、SV和EVI均有较明显下降 ,提示对心肌有一过性轻度的抑制作用。结论 :尼卡地平能有效地减轻气管插管的升压反应 ,但不能防止心动过速的发生。

Objective and Methods: The circulatory responses to tracheal intubation were studied in 38 patients who received nicardipine 15μg/kg (group N, n= 20) or saline 5ml (group C, n= 18) injected intravenously 5min before induction of anesthesia with etomidate 0 3mg/kg and fentanyl 5μg/kg。 Results: Blood pressure did not rise markedly during intubation in group N, but heart rate increased (P<0 01 or 0 05) transiently. Cardiac output increased significantly following injection of nicardipine in group N, but cardiac output, stroke volume and ejection velocity index decreased obviously in both groups during induction and intubation compared with baseline values, indicating hemodynamics were suppressed slightly. Conclusion:Nicardipine is effective in attenuating pressor response to tracheal intubation but can not prevent tachycardia.