摘要
目的对比观察依托咪酯、丙泊酚在体外循环(CPB)心脏直视手术中对血流动力学的影响。方法选择2008年6月至2009年10月该院CPB行心脏手术的全麻患者40例,随机分为依托咪酯组(E组,n=20)和丙泊酚组(P组,n=20),E组用依托咪酯,P组用丙泊酚静脉麻醉,两组其余用药相同,比较两组的麻醉效果。结果诱导后1 min,P组患者动脉收缩压(SBP)、动脉舒张压(DBP)和平均动脉压(MAP)较E组下降明显(P<0.01)。劈胸骨后5 min,两组患者SBP升高(正常血压范围)。体外循环前,P组患者SBP、DBP和MAP下降均较E组多(P<0.01)。切皮后1、5 min时,两组患者的心率较麻醉前下降(P<0.05)。两组患者术后24 h血皮质醇均较术前升高(P<0.05)。结论依托咪酯及丙泊酚能安全用于体外循环心脏直视手术中,均能满足手术需要的麻醉深度,但依托咪酯对血流动力学的抑制较丙泊酚轻。
Objective To investigate the effects of propofol and etomidate on hemodynamics in patients with open heart surgery under cardiopulmonary bypass（CPB）.Methods Forty patients with heart disease were enrolled in the study.They were divided randomly into 2 groups（n=20）：etomidate group（E group）and propofol group（P group）.There were no differences between two groups about medication during operation and postoperation except that the etomidate was used for anesthesia induction and maintenance in E group while the propofol was used in P group.The anesthesia effects of two groups are comparaed with each other.Results A significantly greater decreased of SBP,DBP and MAP（P0.01）was observed in 1 min after induction,but E group was a greater decreased than P group（P0.01）.5 min after sternotomy,the SBP of the two groups had increased（P0.01）and was statistically significantly different（P0.01）,but the scope can be maintained at normal pressure.Both groups of SBP,DBP and MAP decreased before CPB.And the P group of SBP decreased more than the E group.There are significantly statistical difference between two group（P0.01）.1,5 min after skin incision,the heart rate of two groups decreased than baseline（P0.05）.The two groups of cortisol had increased at 24 hours after surgery,which had significantly statistical difference（P0.05）.Conclusion Etomidate and propofol can be safely used under CPB and keep the same depth of anesthesia,but etomidate was lighter on the circulation of the inhibition than propofol.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第25期2520-2522,共3页
Chongqing medicine
基金
广西科技厅科学研究与技术开发计划基金资助项目(桂科攻0816004-27)
