全身麻醉诱导用药对眼内压的影响  

The effects of general anesthetics on intraocular pressure during induction of anesthesia and endotracheal intubation

作　　者：闵苏[1] 房秀生[1] 何大模[1] 

机构地区：[1]重庆医科大学附属第一医院,重庆400016

出　　处：《四川医学》2001年第2期151-153,共3页Sichuan Medical Journal

摘　　要：目的　观察全麻诱导气管插管时异丙酚、硫喷妥钠及乙咪酯对眼内压 (IOP)的影响以及异丙酚与氯胺酮合用时的相互影响。方法　 5 0例 ASA ～ 级择期非眼科手术患者 ,随机分为硫喷妥钠 (SP)组、乙咪酯 (EM)组、异丙酚(P)组、氯胺酮 -异丙酚 (K- P)组、异丙酚 -氯胺酮 (P- K)组。分别于诱导前、注药后、插管前、插管后 1、2、5分钟用 Schiotz眼压计测定 IOP,同时监测平均动脉压 (MAP)和心率 (HR)。结果　 IOP变化　 P组从注药后到插管后 5分钟显著低于诱导前 (P<0 .0 5 ) ,SP组与 EM组注药后各时点有降低趋势 (P>0 .0 5 )。 K- P组注药后 IOP短暂升高 ,但于插管前迅速下降。P- K组变化趋势与 P组基本一致。P、SP、EM组注药后各时点较诱导前下降的百分率分别平均为 - 41.2 8%、- 12 .13%和- 10 .6 2 %。 MAP变化趋势与 IOP基本一致。 HR的变化组内组间均无显著差异 (P>0 .0 5 )。结论　异丙酚在全身麻醉诱导气管插管期间降低 IOP的作用较强而稳定 ;硫喷妥钠、乙咪酯降低 IOP的作用较弱。Objective To observe the effects of propofol,thiopentone,etomidate and propofol with ketamine on intraocular pressur (IOP) during induction of anesthesia and endotracheal intubation.Methods Fifty cases,elective nonophthalmic surgery,ASA grade Ⅰ～Ⅱ,were randomly divided into thiopentone (SP),etomidate (EM),propofol(P),ketamine propofol (K P) and propofol ketamine (P K) groups.IOP,mean arterial pressur (MAP) and heart rate (HR) were measured before induction of anesthesia,after agent injection,before intubation,and 1,2,5 minutes after intubation.Results In the group of propofol,IOP decreased significantly after agent injection until 5 minutes after intubation ( P <0.05),but it was not significantly changed in the thiopentone and etomidate groups.There was a very short duration of IOP increasing in the K P group.The IOP change of the P K group was similar to that of the P group,but the degree of decreasing of IOP was slight.The rates of IOP decreased in the P,SP,EM groups were 42.18, 12.13 and 10.62% respectively.Conclusion Propofol appears to be a suitable agent with decreasing IOP during induction of anesthesia and endotracheal intubation.Propofol combined with ketamine could prevent and mitigate their own side effects.

关 键 词：眼内压 异丙酚 全身麻醉 气管内插管 

分 类 号：R614.2[医药卫生—麻醉学]