依托咪酯联合咪唑安定麻醉诱导用于异位妊娠腹腔镜手术的临床观察  

The clinical observation of etomidate combined with midazolam for anesthesia induction in laparoscopic operation for ectopic pregnancy

作　　者：黄佳洋[1] 刘会长[1] 严国胜[1] 王利祥[1] 

机构地区：[1]湖北省鄂州市中心医院麻醉科,436000

出　　处：《临床外科杂志》2014年第3期204-206,共3页Journal of Clinical Surgery

摘　　要：目的 观察依托咪酯联合咪唑安定麻醉诱导对异位妊娠腹腔镜手术血流动力学及应激反应的影响.方法 行异位妊娠腹腔镜手术的全麻患者69例,麻醉ASAⅠ～Ⅱ级,随机分为三组：丙泊酚诱导组（A组）,依托咪酯诱导组（B组）,依托咪酯联合咪唑安定诱导组（C组）,每组23例,观察比较3组患者诱导前（T0）、诱导后（T1）、插管后1min（T2）、插管后3min（T3）、插管后5min（T4）及插管后10min（T5）各时点血流动力学变化.结果 与T0相比,A组T1、T3、T4、T5时点的收缩压（SBP）、舒张压（DBP）明显降低（P〈0.05）,心率（HR）降低;B组T1时点SBP、DBP降低（P〈0.05）,T2、T3、T4、T5时点的SBP、DBP增高,HR加快,C组在各时点的SBP、DBP、HR无明显变化.结论 在异位妊娠腹腔镜手术的麻醉诱导中,依托咪酯联合咪唑安定麻醉诱导能更好地稳定血流动力学水平,抑制气管插管的应激反应.Objective To observe the effect of etomidate combined with midazolam for anesthesia induction on hemodynamics and stress response of pregnancy laparoscopic operation. Methods Sixty- nine cases of ectopic pregnancy laparoscopic surgery under general anesthesia（ ASA Ⅰ - Ⅱ ）were selected and randomly divided into propofol-induced group （ group A ）, etomidate - induced group （ group B ）, and etomidate ＋ midazolam-induced group （ group C）, each group of 23 cases. The hemodynamics of 3 groups were observed and compared at different time points i. e. before induction （T0） , after induction （T1 ）, I min after intubation（ T2 ） , 3rain after intubation （ T3 ）, 5rain after intubation （ T4 ） and 10min after intubation （ T5 ）. Results Compared with To, in group A, SBP and DBP decreased significantly （ P 〈 0.05 ） and HR decreased at Tj , T3 ,T4 and T5 ; in group B, SBP and DBP decreased （ P 〈 0.05 ） at T1 , and SBP, DBP, HR increased at T2 ,T3 ,T4, and T5 ;in group C, SBP, DBP and HR had no obvious changes at each time point. Conclusion In the laparoscopic operation for ectopic pregnancy during anesthesia induction, etomidate combined with midazolam for anesthesia induction can better stabilize the hemodynamics and inhibit tra- cheal intubation stress response.

关 键 词：依托咪酯 咪唑安定 气管插管 血流动力学 

分 类 号：R614[医药卫生—麻醉学]