三药联合诱导对气管插管心血管反应的预防作用

Co-induction with triple intravenous anesthetics in blunting the cardiovascular responses to tracheal intubation

目的 :比较静脉麻醉药三药联合诱导对气管插管心血管反应的预防作用。方法 :6 0例随机分为 3组 ,分别以硫喷妥钠、丙泊酚和依托咪酯为主药 ,各以咪达唑仑和芬太尼为辅药的三药联合麻醉诱导 ,观察对气管插管前后血压和心率变化。结果 :气管插管时 ,硫喷妥钠组心率较基础值略有增快 (P >0 .0 5 ) ,而丙泊酚和依托咪酯组无明显变化 ;硫喷妥钠和依托咪酯组血压无明显变化 ,丙泊酚组则显著低于基础值 (P <0 .0 5 )。诱导及插管后 ,丙泊酚组低血压和心动过缓发生例数稍高于硫喷妥钠组 ,而依托咪酯组无低血压发生。结论 :三药联合诱导时 ,丙泊酚可完全消除气管插管心血管反应 ,但易引起低血压和心动过缓 。

Objective:To compare the effect of co induction with different triple anesthetics in blunting the cardiovascular responses to tracheal intubation.Methods:Sixty patients were randomly divided into three groups and induced with thiopental,proplfol or etornidate in combination with midazolam and fentanyl respectively.Blood pressure(BP) and heart rate(HR) were observed before and after fracheal intubation.Results:At tracheal intubation,HR in thiopental group was a little higher than the baseline( P >0.05),but in propofol and etomidate groups,the changes were not significant.BP in propofol group was markedly lower than the baseline( P <0.05),but in thiopental and etomidate groups,the changes were not significant.Before and after tracheal intubation,the occurrence of hypotension and bradycardia in propofol group was slightly higher than that in thlopental group,but there was no occurrence of hypotension in etomidate group.Conclusions:Coinduction with triple anesthetics proves to be effective in blunting the cardiovascular responses to tracheal intubation.Proplfol can completely eliminate the cardiovascular responses to tracheal intubation,but facilitate hypotension and bradycardia;thiopenlal and etomidate can only eliminate the increase of BP and HR respectively.