硝酸甘油与美托洛尔预防气管插管所致循环副作用的比较

THE EFFECT COMPARISON BETWEEN NITROGLYCERIN AND METOPROLOL ON CARDIOVASCULAR FUNCTION DURING ENDOTRACHEAL INTUBATION

①目的 比较硝酸甘油与美托洛尔在麻醉诱导中对心率、血压和左室射血功能的影响。②方法 ２４例病人随机分为３ 组，每组８ 例。麻醉诱导均选用芬太尼、硫喷妥钠和琥珀酰胆碱。于静脉诱导后分别静注美托洛尔、硝酸甘油和生理盐水，监测气管插管时平均动脉压（ Ｍ Ａ Ｐ）、心率（ Ｈ Ｒ）和每搏量（ Ｓ Ｖ）变化。③结果 插管后美托洛尔组 Ｍ Ａ Ｐ低于对照组， Ｈ Ｒ 低于对照组及硝酸甘油组， Ｓ Ｖ 高于硝酸甘油组，差异均有显著性（ Ｆ＝ ４．０７～５．９６，ｑ＝ ３．４４～４．４９， Ｐ 均＜ ０．０５）。④结论 美托洛尔与硝酸甘油皆可预防气管插管所致的循环副作用，但美托洛尔作用优于硝酸甘油。

Objective\ To compare the effects of nitroglycerin and metoprolol on blood pressure, heart rate, cardiac output and stroke volume during endotracheal intubation.\ Methods\ 24 patients were randomly divided into three groups: nitroglycerin group ( n =8), metoprolol group ( n =8) and normal saline group ( n =8). Anesthesia was induced with fentanyl, thiopental and succinylcholine. Mean arterial pressure(MAP), heart rate(HR), cardiac output(CO) and stroke volume(SV) were measured during intubation. \ Results\ During incubation, in metoprolol group, MAP was lower than that of control group, HR was lower than that of both control and nitroglycerin group, SV was higher than that of nitroglycerin group ( F=4.07-5.96,q=3.44- 4.49 ,P <0.05).\ Conclusion\ The results of this study show that nitroglycerin and metoprolol can effectively prevent the side offect resulting from intubation. The effect of metoprolol is better than that of nitroglycerin. \;