利多卡因对老年冠心病非心脏手术围插管期心率变异性的影响  

Effects of lidocaine on heart rate variability during endotracheal intubation in the elderly with coronary heart disease undergoing abdominal surgery

作　　者：谢海辉[1] 张曙[1] 石海燕[1] 陈淼[2] 

机构地区：[1]广东省东莞市人民医院麻醉科,523018 [2]遵义医学院附属医院ICU

出　　处：《临床麻醉学杂志》2010年第4期292-294,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究静脉注射利多卡因在全麻诱导气管插管期间对老年冠心病患者自主神经系统功能的影响。方法 90例择期腹部手术老年冠心病患者,随机分为静注利多卡因1.5 mg/kg组(L组)和对照组(P组),每组45例。分别于麻醉前(T0)、麻醉诱导后(T1)及气管插管后(T2)用心率变异功率谱分析(HRPSA)技术观察患者的心率变异性(HRV)变化。结果 T1时两组HRV低频段(LF)、高频段(HF)、低频/高频(LF/HF)和总功率频段(TP)均显著降低(P<0.05),L组LF低于P组(P<0.05);T2时两组LF、HF、LF/HF及TP较T0、T1时均显著升高(P<0.05),T2时L组LF与LF/HF升高程度显著低于P组(P<0.05)。结论静注利多卡因能明显抑制插管操作引起植物神经功能的干扰,有利于维护老年冠心病患者围插管期心脏自主神经功能。Objective To investigate the effects of lidocaine on heart rate variability during endotracheal intubation in the elderly with coronary heart disease （CHD） undergoing abdominal surgery. Methods Ninety CHD patients were randomly divided into two groups of intravenous lidocaine 1.5 mg/kg（group I,） and placebo（group P） before anesthesia induction with 45 cases each. With power spectral analysis of heart rate variability, heart rate variability （HRV） was observed before induction（T0）, after induction（Tl ） and after intubation（T2 ）. Results Compared to at T0, total power of HRV（TP）,low-frequency（LF）. high frequency（HF）, and LF/HF ratio were all significantly lowerd（P〈0.05）, and , LF was lower in group L than that in group P at T1 （P〈0.05）. LF, HF, LF/HF ratio and TP of two groups were significantly higher at T2 than those at T0 and T1 （P〈 0. 05）. The increase of LF/HF ratio at T2 was less in group L than that in group P（P〈0.05）. Conclusion Intravenous lidocaine can reduce the interference of intubation on autonomic function and maintain cardiac autonomic nerve function in the elderly with CHD.

关 键 词：利多卡因 冠心病 心率变异性 气管插管 

分 类 号：R541.4[医药卫生—心血管疾病]