CAJ | 학술논문

目的观察不同剂量的艾司洛尔对预防双腔支气管内插管时心血管反应的临床效果及合适剂量.方法选择ASA Ⅰ～Ⅱ级开胸手术患者60例,随机分为三组,每组20人.A组:注射生理盐水10 ml(对照组),B组:静脉注射艾司洛尔0.5 mg/kg,C组:静脉注射艾司洛尔l mg/kg,记录麻醉诱导前(基础值)、诱导后2 min、插管后即刻、插管后2 min、5 min、10 min的收缩压(SBP)、舒张压(DBP)、心率(HR),计算各对应时点HR和收缩压(SBP)的乘积(RPP).结果与基础值相比,诱导后2 min三组SBP、DBP、HR和RPP均较基础值显著降低(P＜0.05),B组降低的程度比A组更甚,但不及C组低;气管插管后即刻,A组、B组的SBP、DBP、HR和RPP显著升高(P＜0.05),但B组增高的程度明显低于A组(P＜0.05),而C组保持稳定;插管后2 min、5 min、10 min三组SBP、DBP、HR和RPP随时间逐渐趋于基础值,但B、C组仍低于A组(P＜0.05).结论应用0.5 mg/kg和1 mg/kg两种剂量的艾司洛尔均能有效抑制双腔支气管内插管引起的心血管反应,但1 mg/kg艾司洛尔为合适剂量,且血流动力学稳定.
목적 관찰불동제량적애사락이대예방쌍강지기관내삽관시심혈관반응적림상효과급합괄제량.방법 선택ASA Ⅰ～Ⅱ급개흉수술환자60례,수궤분위삼조,매조20인.A조:주사생리염수10 ml(대조조),B조:정맥주사애사락이0.5 mg/kg,C조:정맥주사애사락이l mg/kg,기록마취유도전(기출치)、유도후2 min、삽관후즉각、삽관후2 min、5 min、10 min적수축압(SBP)、서장압(DBP)、심솔(HR),계산각대응시점HR화수축압(SBP)적승적(RPP).결과 여기출치상비,유도후2 min삼조SBP、DBP、HR화RPP균교기출치현저강저(P＜0.05),B조강저적정도비A조경심,단불급C조저;기관삽관후즉각,A조、B조적SBP、DBP、HR화RPP현저승고(P＜0.05),단B조증고적정도명현저우A조(P＜0.05),이C조보지은정;삽관후2 min、5 min、10 min삼조SBP、DBP、HR화RPP수시간축점추우기출치,단B、C조잉저우A조(P＜0.05).결론 응용0.5 mg/kg화1 mg/kg량충제량적애사락이균능유효억제쌍강지기관내삽관인기적심혈관반응,단1 mg/kg애사락이위합괄제량,차혈류동역학은정.
Objective To study the suitable dosage and clinical efficacy of esmolol on inhibiting endobronchial intubated cardiovascular response. Methods Sixty ASA Ⅰ～Ⅱ patients who undergoing thoracic surgery were randomly allocated to one of three groups(20 per group)to receive:0.9% sodium chloride 10 ml (groupA), esmolol 0.5 mg/kg( group B), esmolol 1 mg/kg( groupC ). The systolic blood pressure (SBP), diastolic blood pressure(DBP) and heart rate(HR) were recorded and rate-pressure product(RPP) were calculated before induction(baseline) ,2 min after induction, and at instantly ,2 min ,5 min and 10 min after intubation. Results SBP, DBP, HR, RPP were significantly decreased 2 min after induction of anesthesia as compared to the baseline values in all 3 groups( P ＜ 0.05 ), while immediately after induction SBP、 DBP、 HR、 RPP were significantly increased in group A and B, The intubation responses were strongest in group A, and least in group C.SBP、DBP、HR、RPP reached their highest values significantly later and returned to baseline level after intubation. Conclusion 1 mg/kg esmolol both can inhibit the endobronchial intubated cardiovascular response, but mylky more effectively than 0.5 mg/kg esmolol and it can also keep the hemodynamics steady.