异丙酚、咪唑安定和依托咪酯全麻诱导对眼压的影响  

Effects of propofol,midazolam and etomidate on intraocular pressure during induction

作　　者：毛亚红[1] 孙宏伟[1] 崔敏[1] 袁枫[1] 

机构地区：[1]哈尔滨医科大学附属第一医院麻醉科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2000年第2期126-128,共3页Journal of Harbin Medical University

摘　　要：目的　观察单次诱导剂量的异丙酚、咪唑安定和依托咪酯对眼压的影响 ,并进行对比。方法　选择 45例择期外科手术的病人随机分为 3组 (n =15 ) ,于插管前测基础状态的眼压值 (IOP) ,并监测血压、平均动脉压、心率等。诱导用药为 :静注安定 10mg ,氟芬合剂 1个单位 ;A组 :异丙酚 1 0～ 2 .0mg·kg-1;B组 :咪唑安定 0 1～ 2 .0mg·kg-1,插管后接麻醉机 ,吸入异氟醚。分别在插管瞬间、插管后 5min测IOP值并记录数据。插管时保持头部不过度后仰 ,并要求在 1min内完成。结果　 3组插管后IOP均升高明显 (P <0 0 1) ,与插管前相比B组升高幅度 (4.6 2 73±0 .0 2 )mmHg最小 ,A组 (4.97± 0 .6 )mmHg略高于B组 ,但远低于C组 (6 .5 0 13± 0 .4741)mmHg ,C组升高最明显 (P <0 0 5 )。 3组插管 5min后 ,IOP均下降 ,并且低于插管前的IOP值。结论　单次诱导剂量异丙酚、咪唑安定对于插管所致的反应性高眼压的抑制作用明显好于依托咪酯。全麻插管时 ,使用异丙酚、咪唑安定行麻醉诱导优于依托咪酯 (尤其对于高眼内压患者 )Objective To observe and compare the effect of a inductive dose of propofol,midazolam and etomidate on intraocular pressure(IOP) during anesthesia induction.Methods Fourty five patients,scheduled for elective surgery were randomly divided into three groups( n =15),monitoring IOP,blood pressure and pulse at pre induction.Anesthesia was induced intravenously with diazepam 10mg,droperidol fentanyl 4ml,followed by group A:propofol 1.0～2.0mg·kg -1 ;group B:midazolam 0.1～0.4mg·kg -1 ;group C:etomidate 0.1～0.4mg·kg -1 and scoline 1.4～2.0mg·kg -1 .The trachea was intubated with the suitable size of endotracheal tube in one minute.Anesthesis maintained with Isoflurane O 2.IOP was measured at intubation and 5 min after intubation.Results IOP increasing significantly during induction in all three groups( P <0.01).IOP of group C increased more significantly compared with the other two groups( P <0.05).IOP decreased after intubation was performed following 5min in all three groups.Conclusion Administering of propofol or midazolam is helpful than etomidate in preventing high intraocular pressure during induction.

关 键 词：异丙酚 咪唑安定 依托咪酯 麻醉诱导 眼内压 

分 类 号：R971.2[医药卫生—药品] R775[医药卫生—药学]