合心爽抑制气管内插管期间心血管反应

The Inhibitory Effect of Diltiazem on Cardiovascular Responses to Endotracheal Intubation

观察钙通道拮抗剂──合心爽，对全麻气管内插管期间心血管反应的抑制作用。方法：４０例ＡＳＡＩ级择期全麻手术成年患者，随机分为观察组（ｎ＝ ３０）和对照组（ ｎ＝ １０），Ａｌｌｅｎ试验均为阴性。诱导前用 ＣＡＲＤＩＯ－ＣＡＰ监测仪监测有创桡动脉血压，同时显示心率（ＨＲ）和ＥＣＧ示波。常规诱导。观察组在静注琥珀胆碱前，静脉先给予合心爽０．１５ ｍｇ／ｋｇ。于显露声门、气管插管期间观察有创桡动脉平均压（ＭＡＰ）、心率的变化。结果：全麻诱导期间，显露声门、气管插管操作时，心功能正常者，亦可见显著的ＭＡＰ升高和ＨＲ加速反应。观察组于显露声门、气管内插管期间ＭＡＰ和ＨＲ的变化明显低于对照组（Ｐ＜０．０１）。结论：合心爽能有效地预防气管插管时的心血管反应，起效迅速，效果确切，作用短暂，可用做预防气管插管时心血管反应的有效药物之一。

In order to observe the inhibitory effect of calcium channel antagonist, diltiazem, on cardiovascular response to endotracheal intubation. Methods:40 adult patients with ASA grade I, scheduled for elective operations under general an- esthesia,were randonly divided into observation group(n = 30)and control group(n = 10). The bllld pressure was invasinve- ly determined on patient's radial artery using DETAX cardiocap malfunction monitor,and heart rate and real time electrocar- diography were revealed simultaneously. Induction methods in both groups were the same. The patients in observation group were given diltiazem 0. 15 mg kg^(-1) intravenously prior to injecting muscle relaxant. Changes of MAP and HR were recorded during exposing glottis and endotracheal intubation. Results: The peak values of MAP and HR increases in observation group were much lower than those of the control group(P < 0. 01 ). Conclusion: Diltiazem can effectively prevent the cardiovascular responses to pharyngoscopy and endotracheal intubation during the induction of general anesthesia. It is one of the effective agents in preventing cardiovascular res[pmses to tracheal iptubation.