恬尔心对全麻气管插管时心血管反应的影响

Effects of diltiazem on the cardiovascular system during intubation in general anesthesia

目的 探讨恬尔心对全麻气管插管时心血管反应的影响。方法 择期全麻下手术患者 3 6例 ,排除心血管疾病 ,随机分成 3组 ,组Ⅰ注入生理盐水 10ml ,组Ⅱ注入恬尔心 0 .1mg·kg-1,组Ⅲ注入恬尔心 0 .2mg·kg-1。恬尔心用生理盐水稀释到 10ml ,微泵匀速经另一静脉通路与麻醉诱导药同时注入 ,至插管前 2min注完。观察气管插管前、气管插管后即刻、气管插管后 3min和 5min患者收缩压 (SBP)、舒张压 (DBP)、心率 (HR)和心电图的变化 ,并计算HR×SBP(RPP)。结果 组Ⅱ、组Ⅲ在气管插管后即刻和气管插管后 3minSBP、HR及RPP较组Ⅰ均显著降低 (P <0 .0 5或P <0 .0 1) ,组Ⅲ在气管插管前后各项指标变化最小。结论 气管插管前 2min静脉注射恬尔心 0 .2mg·kg-1对全麻气管插管导致的心血管反应有明显抑制作用。

Objective To study the effects of diltiazem on the cardiovascular system during intubation in general anesthesia.Methods 36 patients undergoing selected surgery were randomly divided into 3 group.All patients received a general anesthesia.Patients in group Ⅰ,Ⅱ and Ⅲ were individually injected with 10?ml normal saline,diltiazem at the dosage of 0.1?mg·kg -1 and diltiazem at the dosage of 0.2?mg·kg -1 .In group Ⅱ and Ⅲ diltiazem were diluted by normal saline into 10?ml,and were injected continuously by syringe pump accompany with inductive drugs through another venous till 2 minutes before intubation.In all patients SBP,DBP,HR and RPP were monitored before and after intubation.Results Compared with that in group Ⅱ and Ⅲ,HR,SBP and RPP in group Ⅰ reduced obviously and that in group Ⅲ changed less.Conclusion Injection with diltiazem at the dosage of 0.2?mg·kg -1 can obviously inhibite the intubation reaction of cardiovascular system during general anesthesia.