艾司洛尔对妇科腹腔镜手术期间应激反应的影响  

Effects of esmolol on stress reaction in patients undergoing gynecological laparoscopic operation

作　　者：伍虹飞[1] 贾东林[1] 

机构地区：[1]北京大学第三医院麻醉科,北京100191

出　　处：《解放军医学杂志》2010年第10期1242-1244,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察艾司洛尔对妇科腹腔镜手术患者手术期间血压(BP)、心率(HR)及血儿茶酚胺浓度的影响。方法 32例全麻下行妇科腹腔镜手术的患者随机分为对照组(A组,n=16)和艾司洛尔组(B组,n=16)。B组于开始气腹前1min经外周静脉注射艾司洛尔0.3mg/kg,然后以50μg/(kg.min)速度持续输注,至麻醉结束拔除气管导管为止;A组给予等量的生理盐水。记录患者术前(T0)、诱导时(T1)、气腹前(T2)、气腹后10min(T3)、气腹后20min(T4)及拔除气管导管后10min(T5)的HR、平均动脉压(MAP),同时测定各时点血中儿茶酚胺类激素(去甲肾上腺素及肾上腺素)的浓度,并进行比较。结果 A组T3、T4时的MAP、HR与T0、T1、T2相比显著升高(P<0.05或P<0.01),T3、T4、T5时的儿茶酚胺浓度较T0、T1、T2时显著增加(P<0.01),而B组各时点的BP、HR、儿茶酚胺浓度比较差异均无统计学意义(P>0.05)。结论艾司洛尔能够抑制气腹引起的BP、HR及儿茶酚胺浓度改变等应激反应,起到稳定内环境的作用。Objective To explore the effects of esmolol on blood pressure, heart rate （HR） and catecholamine concentration in patients undergoing gynecological laparoscopic operation. Methods Thirty two patients undergoing elective gynecological laparoseopic operation under general anesthesia were randomly divided into control group （group A, n = 16） and esmolol group （group B, n = 16）. Patients in group B received esmolol 0. 3mg/kg before pneumoperitoneum, and infusion of esmolol was continued at a rate of 50ug/（kg · min） during operation until extubation. Patients in group A were given equal amount of normal saline as control. The changes in HR and mean arterial pressure （MAP） were recorded before operation （T0）, during anesthesia induction （T1）, before pneumoperitoneum （T2）, 10min after pneumoperitoneum （T3）, 20min after pneumoperitoneum （T4） and 10min after extubation （T5） in all the patients in the two groups. Blood concentrations of eatecholamine （norepinephrine and epinephrine） were measured at each time point. Results In group A, HR and MAP increased significantly at T3 and T4 compared with those at T0, T1 and T2 （P〈0. 05 or P〈0. 01）, and catecholamine concentrations increased significantly at T3, T4 and T5 compared with those at To and T2 （P〈0.01）. In group B, no remarkable differences were found in HR, MAP and catecholamine concentration at each time point. Conclusion Esmolol can inhibit the stress reaction caused by pneumoperitoneum and maintain homeostasis during gynecological laparoscopic operation.

关 键 词：艾司洛尔 应激反应 气腹 儿茶酚胺 

分 类 号：R614[医药卫生—麻醉学]