目的 研究静脉注射利多卡因在全麻诱导气管插管期间对2型糖尿病患者自主神经系统功能的影响. 方法 70例择期腹部手术2型糖尿病患者,采用McLeod改良Wichmann-Hill伪随机数发器生成的随机序列.随机双盲分成利多卡因组(L组,诱导前静脉注射1.5 mg/kg利多卡因)和对照组(C组,诱导前静脉注射等容量氯化钠溶液),每组35例,分别于麻醉诱导前(T0)、麻醉诱导后1 min(T1)、麻醉诱导后3 min(插管前,T2)及插管后1 min(T3)、6 min(T4)用心率(heart rate,HR)变异功率谱分析技术观察患者的心率变异性(heart rate variability,HRV)改变. 结果 与T0比较,T1～T2时,L组低频段(low frequency,LF)(233±131)、(219±98) ms2/Hz和总功率频段(total power,TP)(751±219)、(761±236) ms2/Hz,C组LF (296±99)、(279±103) ms2/Hz,高频段(high frequency,HF)(91±36)、(97±43) ms2/Hz,低频/高频比(LF/HF ratio,LF/HF)(1.8±0.7)、(1.9±0.6)及TP(759±197)、(751±213) ms2/Hz均显著降低(P＜0.05),组间比较,L组LF低于C组(P＜0.05),而L组HF高于C组(P＜0.05)；T3～T4,两组LF、HF及TP均较To显著升高(P＜0.05),而L组的LF/HF较T0差异无统计意义,C组的LF/HF(6.0±1.8)、(5.9±1.9)较T0显著升高(P＜0.05)；组间比较L组LF、TP升高程度显著低于C组(P＜0.05),HF组间差异无统计意义.与T0比较,T1～T2时,两组HR、收缩压(stolic blood pressure,SP)、舒张压(diastolic blood pressure,DP)均显著降低(P＜0.05)；组间比较,L组SP、DP降低程度显著高于C组(P＜0.05),而两组间HR的改变差异无统计学意义.T3～T4,两组HR、SP、DP较麻醉诱导后均显著升高(P＜0.01).组间比较L组HR、SP及DP升高程度显著低于C组(P＜0.05). 结论 全麻诱导气管插管期间2型糖尿病患者对自主神经功能一定的干扰,静注利多卡因能明显抑制插管操作引起的对自主神经功能的干扰,有利于维护2型糖尿病患者围插管期心脏的自主神经调节功能.
目的 研究靜脈註射利多卡因在全痳誘導氣管插管期間對2型糖尿病患者自主神經繫統功能的影響. 方法 70例擇期腹部手術2型糖尿病患者,採用McLeod改良Wichmann-Hill偽隨機數髮器生成的隨機序列.隨機雙盲分成利多卡因組(L組,誘導前靜脈註射1.5 mg/kg利多卡因)和對照組(C組,誘導前靜脈註射等容量氯化鈉溶液),每組35例,分彆于痳醉誘導前(T0)、痳醉誘導後1 min(T1)、痳醉誘導後3 min(插管前,T2)及插管後1 min(T3)、6 min(T4)用心率(heart rate,HR)變異功率譜分析技術觀察患者的心率變異性(heart rate variability,HRV)改變. 結果 與T0比較,T1～T2時,L組低頻段(low frequency,LF)(233±131)、(219±98) ms2/Hz和總功率頻段(total power,TP)(751±219)、(761±236) ms2/Hz,C組LF (296±99)、(279±103) ms2/Hz,高頻段(high frequency,HF)(91±36)、(97±43) ms2/Hz,低頻/高頻比(LF/HF ratio,LF/HF)(1.8±0.7)、(1.9±0.6)及TP(759±197)、(751±213) ms2/Hz均顯著降低(P＜0.05),組間比較,L組LF低于C組(P＜0.05),而L組HF高于C組(P＜0.05)；T3～T4,兩組LF、HF及TP均較To顯著升高(P＜0.05),而L組的LF/HF較T0差異無統計意義,C組的LF/HF(6.0±1.8)、(5.9±1.9)較T0顯著升高(P＜0.05)；組間比較L組LF、TP升高程度顯著低于C組(P＜0.05),HF組間差異無統計意義.與T0比較,T1～T2時,兩組HR、收縮壓(stolic blood pressure,SP)、舒張壓(diastolic blood pressure,DP)均顯著降低(P＜0.05)；組間比較,L組SP、DP降低程度顯著高于C組(P＜0.05),而兩組間HR的改變差異無統計學意義.T3～T4,兩組HR、SP、DP較痳醉誘導後均顯著升高(P＜0.01).組間比較L組HR、SP及DP升高程度顯著低于C組(P＜0.05). 結論 全痳誘導氣管插管期間2型糖尿病患者對自主神經功能一定的榦擾,靜註利多卡因能明顯抑製插管操作引起的對自主神經功能的榦擾,有利于維護2型糖尿病患者圍插管期心髒的自主神經調節功能.
목적 연구정맥주사리다잡인재전마유도기관삽관기간대2형당뇨병환자자주신경계통공능적영향. 방법 70례택기복부수술2형당뇨병환자,채용McLeod개량Wichmann-Hill위수궤수발기생성적수궤서렬.수궤쌍맹분성리다잡인조(L조,유도전정맥주사1.5 mg/kg리다잡인)화대조조(C조,유도전정맥주사등용량록화납용액),매조35례,분별우마취유도전(T0)、마취유도후1 min(T1)、마취유도후3 min(삽관전,T2)급삽관후1 min(T3)、6 min(T4)용심솔(heart rate,HR)변이공솔보분석기술관찰환자적심솔변이성(heart rate variability,HRV)개변. 결과 여T0비교,T1～T2시,L조저빈단(low frequency,LF)(233±131)、(219±98) ms2/Hz화총공솔빈단(total power,TP)(751±219)、(761±236) ms2/Hz,C조LF (296±99)、(279±103) ms2/Hz,고빈단(high frequency,HF)(91±36)、(97±43) ms2/Hz,저빈/고빈비(LF/HF ratio,LF/HF)(1.8±0.7)、(1.9±0.6)급TP(759±197)、(751±213) ms2/Hz균현저강저(P＜0.05),조간비교,L조LF저우C조(P＜0.05),이L조HF고우C조(P＜0.05)；T3～T4,량조LF、HF급TP균교To현저승고(P＜0.05),이L조적LF/HF교T0차이무통계의의,C조적LF/HF(6.0±1.8)、(5.9±1.9)교T0현저승고(P＜0.05)；조간비교L조LF、TP승고정도현저저우C조(P＜0.05),HF조간차이무통계의의.여T0비교,T1～T2시,량조HR、수축압(stolic blood pressure,SP)、서장압(diastolic blood pressure,DP)균현저강저(P＜0.05)；조간비교,L조SP、DP강저정도현저고우C조(P＜0.05),이량조간HR적개변차이무통계학의의.T3～T4,량조HR、SP、DP교마취유도후균현저승고(P＜0.01).조간비교L조HR、SP급DP승고정도현저저우C조(P＜0.05). 결론 전마유도기관삽관기간2형당뇨병환자대자주신경공능일정적간우,정주리다잡인능명현억제삽관조작인기적대자주신경공능적간우,유리우유호2형당뇨병환자위삽관기심장적자주신경조절공능.
Objective To explore effects of the autonomic nervous system function on Intravenous injection of lidocaine during intubation in patients with type 2 diabetes.Methods 70 patients undergoing abdominal surgery were randomly divided into lidocaine group (group L,n=35,with intravenous 1.5 mg/kg lidocaine) and control group (group C,n=35,with intravenous sodium chloride solution),The changes in heart rate variability (HRV) were recorded at following time points:prior to anesthesia (T0),1 min after anesthesia induction (T1),3 min after anesthesia induction and prior to intubation (T2),1 min after intubation (T3),the HRV was observed with power spectral analysis.Results After induction of anesthesia (T1,T2),group L of low-frequency(LF)(233±131),(219±98) ms2/Hz,and total power of HRV spectrum(TP)(751±219),(761±236) ms2/Hz,group C of LF(296±99),(279± 103) ms2/Hz,high frequency (HF) (91 ±36),(97±43) ms2/Hz,low frequency/high frequency ratio (LF/HF) (1.8±0.7,1.9±0.6) and TP (759±197),(751±213) ms2/Hz were significantly lower than T0,inter-group comparison group L LF lower than group C; but HF higher than group C.After intubation (T3,T4),two groups of LF,HF and TP were significantly higher than T0 (P＜0.05),D group of LF/HF were not significantly higher than T0,however,group C of LF/HF (6.0±1.8,5.9±1.9) were significantly higher than T0 (P＜0.05),inter-group comparison GroupL with LF,TP increased significantly lower than the groupC (P＜0.05),HF inter-group difference was not significant.After induction of anesthesia (T1,T2),both groups of HR,SP,DP lower than T0.inter-group comparison group L SP,DP lower than group C; HR inter-group difference was not significant.After intubation (T3,T4),two groups of HR,SP,DP were significantly higher than T0 (P＜0.05),inter-group comparison group L H R,SP,DP lower than group C (P＜0.05).Conclusions autonomic nervous system function changed following tracheal intubation during induction of anesthesia in patients with type 2 diabetes,Intravenous lidocaine inhibit those changes.This is beneficial to maintain cardiac autonomic nerve function in patients with coronary artery disease during intubation.
