艾司洛尔复合利多卡因对老年病人气管插管时血流动力学的影响  

Effects of esmolol with lidocarine on hemodynamic reaction in elderly patients undergoing tracheal intubation

作　　者：韩雪敏[1] 李春华[1] 汤海珍[1] 

机构地区：[1]安徽省淮北市人民医院麻醉科,安徽淮北235000

出　　处：《安徽医药》2012年第10期1507-1509,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的观察艾司洛尔复合利多卡因预防气管插管引起血流动力学变化的效果。方法 50例择期全麻手术病人随机分为实验组、对照组(n=25),两组病人诱导方法相同:咪唑安定0.05 mg.kg-1,依托咪酯0.2 mg.kg-1,舒芬太尼0.4μg.kg-1,维库溴铵0.1 mg.kg-1,实验组病人在诱导后静脉注射艾司洛尔0.5 mg.kg-1和利多卡因1 mg.kg-1,对照组病人则静脉注射生理盐水。分别记录诱导前(T0)、诱导后1 min(T1)、插管后即刻(T2)、插管后1 min(T3)、3 min(T4)、5 min(T5)各时点的收缩压(SBP)、舒张压(DBP)、心率(HR)及脉搏氧饱和度、呼气末二氧化碳浓度及心电图变化。结果实验组病人SBP、DBP、HR插管后较基础值有短时间轻度升高(P>0.05);对照组病人在插管后HR较基础值明显增快(P<0.01),明显高于实验组(P<0.05);插管后即刻、1 min、3 min SBP、DBP较基础值明显升高(P<0.01),明显高于实验组(P<0.05)。结论艾司络尔复合利多卡因在老年病人全麻诱导时应用可有效缓解气管插管时的心血管反应,使血流动力学更加平稳,这在老年病人可减少心肌氧耗,降低麻醉风险,提高围手术期安全性。Objective To observe the effects of esmolol with lidocarine on hemodynamic reaction in elderly patients undergoing tracheal intubation.Methods Fifty patients undergoing elective operation with general anesthesia were divided into two groups randomly：experimental group（n=25）and control group（n=25）.Patients in both groups were induced by the same methods：Midazolam 0.05 mg·kg-1,etomidate 0.2 mg·kg-1,sufentanil 0.4 μg·kg-1,vecuronium 0.1 mg·kg-1.Patients in experimental group were given esmolol 0.5 mg·kg-1 and lidocaine 1 mg·kg-1 intravenous after induction,and the patients in control group were given saline intravenously.The changes of systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）and pulse oxygen saturation,carbon dioxide concentrations in expiratory-end and electrocardiography on time of before induction（T0）,after induction 1 min（T1）,after intubation immediately（T2）,after 1min（T3）,3 min（T4）,5 min（T5）were recorded.Results SBP,DBP,HR of patients in experimental group after intubation elevated mildly with a short time compared with basic value（P0.05）;the HR of patients in control group increased significantly after intubation compared with basic value（P0.01）,and higher than experimental group significantly（P0.05）;SBP,DBP of immediately after intubation,1 min,3 min were elevated significantly compared to the basic values（P0.01）,and higher than those of experimental group significantly（P0.05）.Conclusion Esmolol with lidocaine can alleviate the cardiovascular response in tracheal intubation in elderly patients during induction of general anesthesia effectively,and keep stable hemodynamics,which can lower myocardial oxygen consumption in the elderly patients,lower risk of anesthesia and increase safety during peri-operation period.

关 键 词：艾司洛尔 利多卡因 老年病人 气管插管 血流动力学 

分 类 号：R614[医药卫生—麻醉学]