艾司洛尔与芬太尼预防气管插管时心血管副反应的比较

Comparative Study of Esmolol and Feutanyl on Circulatory Response During Tracheal Intubation

目的 :比较 1mg/kg、2mg/kg艾司洛尔 (Esmolol)与 3μg/kg芬太尼 (Fentangl)降低气管插管时高循环动力的效果。方法 :45例择期手术的全麻病人 ,随机分为 3组 :A组Esmolol 1.0mg/kg ;B组Esmolol 2 .0mg/kg ;C组Fen tanyl3 .0 μg/kg。记录诱导前、插管前、插管后 1,2 ,3 ,5 ,10min的HR、SBP、DBP及ECG的变化。结果 :B组HR在插管后 1min高于诱导前 (P <0 .0 5 ) ,A组在插管后 1～ 3min ,C组在插管后 1～ 5minHR均高于诱导前 (P <0 .0 5 ) ,B组HR在插管后 1～ 5min显著低于C组。B组SBP在插管后各时点相对稳定 ,A组在插管后 1～ 2min ,C组在插管后 1～ 3minSBP均较诱导前显著升高 (P <0 .0 5 )。B组RPP值相对稳定 ,且低于 12 0 0 0 ,A、C两组插管后 1～ 3minRPP高于诱导前 (P <0 .0 5 ) ,且RPP >12 0 0 0 ,B组插管后 1～ 3minSBP、RPP均低于C组。结论 :艾司洛尔抑制插管反应效能与剂量有关 ,2mg/kg能有效抑制插管时心血管副反应 ,且效果优于

Abstract: To campare 1.0 mg/kg Esmolol, 2.0 mg/kg Esmolol and 3.0 μg/kg fentanyl on circulatory response during tracheal intubation. Methods: Forty five patients, ASAⅠ Ⅱ, undergoing elective surgery under general anesthesia were randomly divided into three groups. Patients in Group A, Group B and Group C were injected intravenously with Esmolol 1.0 mg/kg, 2.0 mg/kg and fentanyl 3.0 μg/kg,respectively, before induction. HR, SBP, DBP and RPP were recorded before administration, before intubation and 1,2,3,5 and 10 min after intubation. Results: HR in Group B increased at 1 min after intubation. HR in Group A at 1～3 min and Group C at 1～5 min were higher than that in preoperation. SBP in group A at 1～2 min and Group C at 1～3 min after intubation were significantly higher than that before administration (P<0.05). SBP in group B was stabls. RPP in group B was less than 12 000 during the whole procedure and lower than that in Group A and Group C. Conclution: 2.0 mg/kg Esmolol may attenuate circulatory response and the result is better effect than 3.0 μg/kg fentanyl during intubation.