麻黄素/艾司洛尔对维库溴铵插管条件的影响

Effects of Ephedrine/Esmolol on Intubating Conditions with Vecuronium

目的观察预注麻黄素和艾司洛尔对维库溴铵预给药诱导插管条件的影响。方法选择全麻患者90例,ASAⅠ或Ⅱ级,年龄23～59岁,随机分为3组(n=30):对照组(C组)、麻黄素组(E组)和艾司洛尔组(ES组)。在插管前2.5 min注入生理盐水/麻黄素/艾司洛尔,对维库溴铵预给药诱导后下颌松弛度、声门位置和插管反应进行评分并记录插管前和插管后5 min平均动脉压和心率。结果 E组下颌松弛度评分显著高于C组(P<0.05),而ES组下颌松弛度评分显著低于C组(P<0.05),E组插管反应评分显著高于C组(P<0.05),E组和C组相比达到临床可接受的插管条件差异有统计学意义(P<0.05)。E组插管后有短时间血压升高和心率增快(P<0.05),而ES组也有一过性心率减慢(P<0.05),但无不良反应发生。结论预注麻黄素或艾司洛尔能显著改变维库溴铵预给药方法的插管条件,并无不良反应发生。

Objective To investigate the effects of ephedrine and esmolol on intubating conditions folio.wing priming with vecuronium. Methods Ninety ASA Ⅰ or Ⅱ patients aged 23 - 59 years undergoing general anesthesia were divided into 3 groups （ n = 30 patients each） ： control group（ C group） ,ephedrine group（ E group） and esmolol group（ ES group）. Normal saline/ephedrine/ esmolol was administered two and a half minutes before intubation, then jaw relaxation ; vocal cord position and response to intubation were scored following priming with vecuronium, and mean arterial pressure and heart rate before and after 5 minutes after intubation were recorded. Results Jaw relaxation scores in E group were markedly higher than those in C group （ P 〈 0.05 ） , and jaw relaxation scores in ES group were significantly lower than those in C group （ P 〈 0.05 ） ; response to intubation scores in E group was markedly better than that in C group（ P 〈 0.05 ） i there were significant differences of clinically acceptable intubating conditions between E group and C group（P 〈0.05）. Elevated blood pressure and increased heart rate emerged at short time after intubation in E group（ P 〈 0.05 ） and decreased heart rate presented transiently in ES group（ P 〈 0.05 ）, but no adverse effects were observed. Conclusion Pretreat with ephedrine or esmolol could significantly change intubating condition following priming with vecuronium and no adverse effects were observed.