小剂量艾司洛尔预先静脉注射减轻高血压冠心病患者气管插管反应的疗效观察  

Observation on the Efficacy of Small Dose of Esmolol Intravenous Pre-injection Alleviating the Reaction of Tracheal Intubation for Patients with Hypertension and Coronary Heart Disease

作　　者：王光福 徐小波[2] 李河志 赵辉 刘绍靖 

机构地区：[1]武装警察部队四川省总队成都医院麻醉科,成都610041 [2]成都医学院附属医院麻醉科,成都610501

出　　处：《医学综述》2016年第2期403-406,共4页Medical Recapitulate

摘　　要：目的观察小剂量艾司洛尔预先静脉注射在减轻高血压冠心病患者气管插管反应的作用。方法选取2009年2月至2012年10月在武装警察部队四川总队成都医院行全身麻醉手术的高血压冠心病患者60例,根据随机数字表法分为艾司洛尔组和对照组,各30例。艾司洛尔组在麻醉插管前5 min给予小剂量艾司洛尔(0.7 mg/kg);对照组仅给予0.9%Na Cl注射液,两组麻醉诱导和维持方法相同,分别监测并记录麻醉诱导前、诱导后、插管即刻、插管后1、3、5 min时心率和平均动脉压变化。结果对照组插管即刻、插管1、3、5 min的平均动脉压较诱导前有明显升高[(120±15)mm Hg(1 mm Hg=0.133 k Pa)、(118±23)mm Hg、(115±10)mm Hg、(112±14)mm Hg比(98±14)mm Hg],心率明显增快[(88±8)次/min、(94±15)次/min、(91±10)次/min、(93±10)次/min比(76±4)次/min],艾司洛尔组的平均动脉压[(101±11)mm Hg、(104±18)mm Hg、(101±10)mm Hg、(98±10)mm Hg比(98±14)mm Hg],心率[(78±4)次/min、(81±12)次/min、(80±7)次/min、(78±5)次/min比(75±7)次/min]分别较诱导前有轻度升高,但变化幅度不大。两组比较差异有统计学意义(P<0.05)。结论小剂量艾司洛尔预先注射能够有效减轻高血压冠心病患者气管插管时的心血管反应。Objective To observe the effect of intravenous pre-injection of small dose of esmolol on alleviating the impact of tracheal intubation on patients with hypertension and coronary heart disease. Methods Total of 60 patients with hypertension and coronary heart disease undergoing general anesthesia operations at Chengdu Armed Police Corps Hospital from Feb. 2009 to Oct. 2012 were selected, and were divide into esmolol group and control group according to random number table method, with 30 patients in each group. The esmolol group was injected with small dose of esmolol（0. 7 mg/kg） 5 minutes prior to the anesthetic intubation;the control group was only given with 0.9% NaC1 saline. The induction and maintenance of anes- thesia were kept the same for the two groups. The changes of heart rate and mean arterial pressure were moni- tored and recorded before and after the induction of anesthesia, immediately after intubation, and 1,3 and 5 minutes after intubation. Results The mean arterial pressure and heart rate of the control group after induction ,immediately after intubation, and 1,3 and 5 minutes after intubation were significantly increased than before induction [ （ 120±15 ） mmHg, （ 118±23 ） mmHg, （ 115±10 ） mmHg, （ 112±14 ） mmHg vs （ 98±14） mmHg;（88±8） beats/min, （94±15） beats/rain, （91±10） beats/min, （93±10） beats/rain vs （76±4 ）beats/min ]. The mean arterial pressure and heart rate of esmolol group compared with before induction were mildly increased,[ （101±11） mmHg,（104±18） mmHg,（101±10） mmHg, （98±10） mmHg vs（98±14）mmHg;（78±4） beats/rain, （81±12） beats/min,（80±7） beats/min,（78±5） beats/min vs （75±7） beats/min ]. The differences between the two groups had statistical significance （P 〈 0. 05 ）. Conclusion Intravenous pre-injection of small dose of esmolol cam effectively alleviate the cardiovascular reaction of tracheal intubation for patients with hypertension and coronary heart disease.

关 键 词：高血压 冠心病 小剂量艾司洛尔 气管插管 

分 类 号：R614[医药卫生—麻醉学]