不同麻醉药全麻诱导对循环及血糖的影响  

Effects of Different Anesthetics on Hemodynamics and Plasma Glucose

作　　者：闫相华[1] 张甲平[1] 

机构地区：[1]解放军第18医院麻醉科,新疆叶城844900

出　　处：《临床军医杂志》2004年第6期39-40,共2页Clinical Journal of Medical Officers

摘　　要：目的　观察几种不同的麻醉药物在全麻诱导过程中患者循环及血糖的变化 ,以评价麻醉药物对循环及血糖影响。方法　 43例在全麻下行择期手术的病人随机分为三组 ,Ⅰ级为普鲁泊福组 2 5mg/kg ,Ⅱ组为硫喷妥钠组 5mg/kg ,Ⅲ组为依托咪酯组 0 3mg/kg ,各组分别记录麻醉诱导前 (T1 )、窥喉 (T2 )、插管后 2min(T3)、5min(T4 )、15min(T5)时病人的收缩压 (SBP)、舒张压 (DBP)、平均动脉压 (MAP)、心率 (HR) ,同时抽静脉血测各时点的血糖变化。结果　硫喷妥钠组和依托咪酯组病人于T2～ 4 血压明显高于普鲁泊福组 (P <0 0 5或P <0 0 1) ,各组间心率变化无差别 ;三种诱导药在T3～ 5血糖升高显著 (P <0 0 5或P <0 0 1) ,而依托咪酯血糖升高更为明显 (P <0 0 1)。结论　普鲁泊福诱导插管能抑制机体应激反应 ,对血糖的影响相对较小 ,适用于术前血糖高的病人。Objective o evaluate the depression effects of propofol and thiopental and etomidate on stress response reflected by changes of hemodynamics and plasma glucose during the induction of anesthesia. Methods All the 43 patients who would undergoing operation under general anesthesia were at random divided into group Ⅰ (propofol, n=21) and group Ⅱ (thiopental, n=21) and group Ⅲ (etomidate, n=21). Propofol (2.5mg/kg), thiopental (5mg/kg) and etomidate 0.3mg/kg were administered for the induction of anesthesia respectively in group Ⅰ, Ⅱ and Ⅲ. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and heart rate (Hr) were recorded and plasma glucose level was examined before the induction (T 1), and immediately after prying into throat (T 2), and in 2min (T 3), 5min (T 4) and 15min (T5) after intubatton.Results The levels of plasma glucose of the three groups increased significantly at T 3～5 (P<0.05 or P<0.01). The level of group Ⅲ increased more significantly than that of group Ⅰ and Ⅱ (P<0.01). The SBP, DBP and MBP increased more significantly in group Ⅱ and Ⅲ than in group Ⅰ at T 2～4 (P<0.01 or P<0.05P<0.05). Conclusion The results suggest that propofol can blunt effectively the stress response induced by intubation.

关 键 词：二异丙酚 全身麻醉 血流动力学 血糖 

分 类 号：R614.2[医药卫生—麻醉学] R446.11[医药卫生—外科学]