异丙酚与硫喷妥钠混用麻醉诱导对血流动力学的影响

EFFECTS OF ANESTHESIA INDUCTION WITH PROPOFOL-THIOPENTAL MIXTURE ON HEMODYNAMICS

目的 :观察异丙酚与硫喷妥钠混用麻醉诱导对血流动力学的影响。方法 :2 6例病人随机分为A、B两组 ,每组 1 3例。A组诱导用芬太尼 4 μg/kg、维库溴铵 0 8mg/kg、异丙酚 2 0mg/kg、琥珀胆碱 1 5mg/kg ;B组用芬太尼 4 μg/kg、维库溴铵 0 8mg/kg、1 0 %异丙酚与 2 0 %硫喷妥钠 1∶1混合液 (剂量为异丙酚 1 0mg/kg、硫喷妥钠 2 0mg/kg)、琥珀胆碱 1 5mg/kg。记录诱导前、诱导后和插管后 1 ,3,5min时收缩压 (SBP)、舒张压 (DBP)、平均动脉压 (MAP)和心率 (HR)变化。 结果 :诱导后两组病人SBP、DBP和MAP均较诱导前明显降低 (P <0 0 5 ,P <0 0 1 ) ,A组较B组降低更为明显 (P <0 0 5 )。插管后两组病人SBP、DBP和MAP较诱导后明显增加 (P <0 0 5 ,P <0 0 1 ) ,但均未超过诱导前水平 (P >0 0 5 )。两组病人各时期HR无明显变化 (P >0 0 5 )。结论 :1 0 %异丙酚与 2 0 %硫喷妥钠按 1∶1比例混合后用于麻醉诱导(剂量为异丙酚 1 0mg/kg ,硫喷妥钠 2 0mg/kg) ,可减轻诱导后血压下降的程度 ,与芬太尼 4 μg/kg伍用 ,可有效控制气管插管引起的心血管反应。

Objective:To observe the effects of anesthesia induction with propfol thiopental mixture on hemodynamics.Methods:Twenty six patients were randomly divided into two groups,group A( n =13) and group B( n =13).Anesthesia was induced with fentanyl 4 μg/kg,vacuronium 0 8 mg/kg,propofol 2 0 mg/kg,succinylcholine 1 5 mg/kg in group A and fentanyl 4 μg/kg,vacuronium 0 8 mg/kg,a 1∶1 volume mixture of 1 0% propofol and 2 0% thiopental (propofol 1 0 mg/kg and thiopental 2 0 mg/kg),succinylcholine 1 5 mg/kg in group B.Systolic blood pressure (SBP),diastolic blood pressure (DBP),mean arterial pressure (MAP) and heart rate (HR) were recorded at pre induction,post induction and l,3,5 min of post intubation.Results:Compared with those of pre induction,SBP,DBP and MAP of post induction decreased significantly in both groups ( P <0 05, P <0 01),and decreased more significantly in group A than in group B( P <0 05).Compared with those of post induction,SBP,DBP and MAP increased significantly at 1,3,5 min of post intubation in both groups ( P <0 05, P <0 01),without exceeding those of pre inducion( P >0 05).There were no significant changes in HR in both groups ( P> 0 05).Conclusion:Anesthesia induction with a 1∶1 volume mixture of 1 0% propofol and 2 0% thiopental (propofol 1 0 mg/kg and thiopental 2 0 mg/kg)may blunt the post induction hypotension,and with fentanyl 4 μg/kg,can effectively control the hemodynamic responses to endotracheal intubation.