围术期倍他乐克对非心脏手术患者皮质醇和血糖的影响  

The influences of perioperative metoprolol on blood cortisol and glucose in patients undergoing noncardiac surgery

作　　者：刘瑶[1] 张丽娜[1] 贺民[1] 蔡宏伟[1] 郭曲练[1] 

机构地区：[1]中南大学湘雅医院麻醉科,长沙市410008

出　　处：《临床麻醉学杂志》2006年第8期611-613,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨围术期倍他乐克对60岁以上非心脏手术患者皮质醇和血糖的影响。方法30例60-75岁拟行择期非心脏手术患者被分为倍他乐克组和对照组，每组15例。倍他乐克组患者于麻醉诱导前和气管插管后分别静脉注射0．5mg和1．5mg倍他乐克。围术期监测血压、HR、ECG、血皮质醇和血糖水平。结果倍他乐克组收缩压≥180mmHg和HR≥90次／分的累积时间明显少于对照组（P〈0．05或P〈0．01）；心肌缺血发生率倍他乐克组13％，对照组30％（P〈0．01）；两组患者血皮质醇水平在手术开始后1h和患者入PACU后15min均明显高于麻醉前（P〈0．05或P〈0．01），血糖水平在患者入PACU后15min也明显高于麻醉前（P〈0．05）。结论倍他乐克不能减轻非心脏手术患者围术期应激性激素的释放。Objective To investigate the influences of perioperative metoprolol on blood cortisol and glucose in elderly patients undergoing noncardiac surgery. Methods Thirty 60-75years old patients undergoing selective noncardiac surgery were assigned to metoprolol group and control group with 15 cases each. The patients of metoprolol group received metoprolol 0.5 mg and 1.5 mg,iv slowly before induction of intravenous anesthesia and after tracheal intubation, respectively. BP, HR＇,ECG, blood cortisol and glucose were observed intraoperatively. Results The total time when SBP≥180 mmHg and HR≥90 beats/min persisted was less in metoprolol group than that in control group（P〈 0. 05 or P〈0.01）. The incidence of myocardial ischaemia episode was 13% in metoprolol group,and 30% in control group （P〈0. 01）. Blood cortisol and glucose levels were significantly elevated at 1 h during operation and 15 min after entry PACU compared with the baselines in both groups （P〈 0. 01）. Conclusion Metoprolol does not reduce the perioperative release of neuroendocrine stress response hormone in elderly patients undergoing noncardiac surgery.

关 键 词：Β阻滞剂 心肌缺血 应激反应 皮质醇 

分 类 号：R614[医药卫生—麻醉学]