健忘镇痛慢诱导麻醉插管对冠心病患者QTc间期的影响

Effect of anesthesia and intubation with forgetfulness analgesic slow induction on QTc interval in patients with coronary heart disease

目的探讨健忘镇痛慢诱导麻醉插管对冠心病患者校正QT(QTc)间期的影响。方法择期行开腹手术的老年冠心病患者80例均分为两组:A组行健忘镇痛慢诱导麻醉;B组行常规气管插管麻醉。记录诱导前(T0)、气管插管前1min(T1)、插管时(T2)、插管后30s(T3)、2min(T4)和5min(T)时的心率(HR)、平均动脉压(MAP)及QTc间期。结果 A组T3时的QTc间期较T0明显延长[(385.1±19.8)ms vs.(374.7±16.7)ms](P<0.05)。B组T3、T4和T5时的QTc间期均较T0延长[(414.9±19.5)ms,(406.9±18.1)ms和(401.1±17.7)ms vs.(375.2±18.4)ms](P<0.05)。A组患者插管期HR和MAP较为平稳,但B组波动较大。结论老年冠心病患者采用健忘镇痛慢诱导麻醉有助于减弱气管插管时HR和MAP波动,减轻气管插管诱发的QTc间期延长。

Objective To investigate the effect of anesthesia and intubation with forgetfulness analgesic slow induction on corrected QT（QTc）interval in elderly patients with coronary heart disease（CHD）.Methods Eighty patients with CHD undergoing selective abdominal surgery were randomly assigned into two groups of A（given forgetfulness analgesic slow induction,40cases）and B（using conventional induction and intubation,40cases）.The heart rate（HR）,mean arterial pressure（MAP）and QTc interval were recorded before induction（T0）,at 1 min before induction（T1）,during intubation（T2）,at 30s（T3）,2min（T4）and 5min（T5）after intubation.Results The QTc interval of group A was longer at T3than that at T0[（385.1±19.8）ms vs.（374.7±16.7）ms]（P〈0.05）.The values of QTc interval in group B at T3,T4and T5were（414.9±19.5）ms,（406.9±18.1）ms and（401.1±17.7）ms,respectively,which were longer than（375.2±18.4）ms at T0（P〈0.05）.The HR and MAP of group A were changed slightly during intubation,which of group B were fluctuated remarkably.Conclusion The forgetfulness analgesic slow induction of anesthesia is helpful in reducing the fluctuation of HR and MAP during intubation and attenuating the prolongation of QTc interval in CHD patients undergoing intubation.