艾司洛尔对胸腔镜手术双腔支气管插管时心血管反应的影响

Effect of intravenous esmolol on cardiovascular responses to doule-lumen tubes in thoracoscopic surgery.

目的探讨艾司洛尔对胸腔镜手术双腔支气管插管时心血管反应的影响。方法择期胸腔镜手术患者22例,ASA分级为Ⅰ～Ⅱ级,年龄21～63岁,随机分成对照组和艾司洛尔组,每组11例。诱导前对照组和艾司洛尔组分别静脉注射生理盐水和艾司洛尔,然后进行麻醉诱导插入双腔支气管导管。结果插管时对照组的平均动脉压(MAP)较插管前明显升高,心率(HR)明显增快,插管1min和5min的MAP和HR较插管前差异有统计学意义(P<0.05),3min差异有显著统计学意义(P<0.01);艾司洛尔组心血管反应较对照组轻,差异无统计学意义(P>0.05)。插管时两组患者的血液动力学上的改变相比较,插管1min和5min的MAP和HR较插管前差异有统计学意义(P<0.05),3min差异有显著统计学意义(P<0.01)。结论静脉注射艾司洛尔对胸腔镜手术双腔气管插管时心血管反应有一定的抑制作用。

Objective To evaluate the effects of esmolol on cardiovascular responses to doule-lumen tubes （DLT） in thoracoscopic surgery. Methods Twenty-two ASAⅠ～Ⅱ patients （aged 21～63 years） scheduled for elective thoracoscopic surgery were randomly divided into two groups： the control group （n=11） and the esmolol group （n=11）. The patients received normal saline in the control group and esmolol 1 mg/kg in the esmolol group one minute before intubation. Results In the control group, the mean arterial pressure （MAP） and heart rate （HR） were significantly increased at 1 min and 5 min （P0.05） or very significantly increased at 3 min （P0.01） after intubation. while those in the esmolol group either remained unchanged or increased only slightly （P0.05）. Statistically significant differences were found in MAP and HR at 1 min, 3 min and 5 min （P0.05） after intubation between the two groups. Conclusion Esmolol may effectively attenuate the cardiovascular responses to DLT in thoracoscopic surgery.