艾司洛尔、拉贝洛尔和尼卡地平对气管插管期间心血管反应、脑电双频指数和熵指数的影响  

Effects of esmolol,labetalol and nicardipine on hemodynamic response and changes of bispectrai index and entropy during intubation

作　　者：腾士勇[1] 陶国荣[1] 彭章龙[1] 于布为[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院麻醉科,200025

出　　处：《临床麻醉学杂志》2008年第9期756-758,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨艾司洛尔、拉贝洛尔和尼卡地平对气管插管期间心血管反应、腑电双频指数(BIS)和熵指数的影响。方法 60例择期腹部手术的患者,随机均分为四组:艾司洛尔组、拉贝洛尔组和尼卡地平组、生理盐水组。四组均采用丙泊酚分步靶控输注诱导,BIS≤80时各组分别静注艾司洛尔0.3 mg/kg、拉贝洛尔0.04 mg/kg、尼卡地平0.03 mg/kg 和生理盐水。当 BIS≤50后1 min行气管插管。观察反应熵(RE)、状态熵(SE)、BIS、HR 和 MAP 的变化。结果艾司洛尔组、拉贝洛尔组和尼卡地平组 MAP、HR 在插管后1 min 显著高于插管前1 min(P<0.05或 P<0.01)。各组RE、SE、BIS 插管前后差异无统计学意义。结论艾司洛尔、拉贝洛尔或尼卡地平均可减轻患者气管插管时的心血管反应,但对 BIS、RE、SE 无显著影响。Objective To investigate the effects of esmolol, labetalol and nicardipine on hemodynamie response and changes of bispeetral index （BIS）, response entropy （RE） and state entropy （SE） during orotracheal intubation. Methods Sixty patients undergoing selective abdominal surgery were randomly divided into 4 groups of esmolol（group E）, labetalol（group L）, nicardipine （group N） and control（group C）. Anesthesia was induced with propofol TCI. When BIS decreased to 80, the patients in group E received a bolus of esmolol 0.3 mg/kg, in group L labetalol 0. 04 mg/kg,in group N nieardipine 0.03 mg/kg and in group C normal saline. One minute after BIS decreased to 50, the trachea was intubated. RE, SE, BIS, HR, MAP were recorded before induction,at 1, 2 min after induction, 1 min before intubation, and 1, 2 min after intubation. Results Compared with the preinduction value, HR, MAP increased significantly after intubation in group C, HR increased significantly after intubation in group N, while there was no significant changes in group E or group L. RE,SE,BIS decreased significantly after induction, and there was no significant dlfference during intubation. Conclusion Esmolol, labetalol or nicardipine can reduce cardiovascular response to tracheal intubation without any significant influence on BIS, RE and SE.

关 键 词：艾司洛尔 拉贝洛尔 尼卡地平 气管插管 脑电双频指数 熵指数 

分 类 号：R614[医药卫生—麻醉学]