不同给药剂量艾司洛尔对神经监测下甲状腺手术麻醉诱导效果的影响  

Different dosages of esmolol on the effect of anesthetic induction for thyroid surgery under neural monitoring

作　　者：李静[1] 曾玲双[2] Li Jing;Zeng Lingshuang(Department of Anesthesiology,the Second Affiliated Hospital of Xi’an Medical University,Xi’an 710038,China;Department of Anesthesiology,the First People’s Hospital of Yinchuan,Yinchuan 750001,China)

机构地区：[1]西安医学院第二附属医院麻醉科,710038 [2]宁夏银川市第一人民医院麻醉科,750001

出　　处：《中华普通外科学文献（电子版）》2018年第4期269-272,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的研究不同给药剂量艾司洛尔对神经监测下甲状腺手术麻醉诱导效果影响情况。方法选取2016年10月至2017年10月在西安医学院第二附属医院诊断并经手术治疗的甲状腺手术患者68例,按照随机数字表法分为四组,每组17例。麻醉诱导后,A组给予10 ml 0.9%氯化钠溶液,B组给予0.5 mg/kg艾司洛尔,C组给予1 mg/kg艾司洛尔,D组给予1.5 mg/kg艾司洛尔,观察不同给药剂量艾司洛尔对神经监测下甲状腺手术麻醉诱导效果影响情况。结果 (1)4组患者在诱导前心率、收缩压、舒张压差异无统计学意义;(2)A组、B组在插管时、插管后60、180、300 s的心率值较诱导后均明显增高,差异有统计学意义(P<0.05),C组在插管后180、300 s的心率值较诱导后升高,差异有统计学意义(P<0.05),D组在插管后300 s的心率值较诱导后升高,差异有统计学意义(P<0.05);(3)C组、D组在插管时、插管后60、180 s的心率值较A组低,差异有统计学意义(P<0.05);C组、D组在插管时、插管后60 s的收缩压较A组低,差异有统计学意义(P<0.05);(4)4组在插管时、插管后的血液流变明显高于麻醉诱导后(P<0.05);(5)4组间发生窦性心动过缓比率差异有统计学意义(P<0.05);艾司洛尔插管后静注阿托品,心动过缓患者最低心率较静注阿托品前差异有统计学意义(P<0.05)。结论不同给药剂量下艾司洛尔可显著抑制甲状腺手术麻醉诱导插管时心血管异常反应,值得临床给予关注。Objective To study the effect of esmolol with different concentrations on the induction of anesthesia induced by thyroidectomy.Methods A total of sixty-eight thyroid patients diagnosed and surgically treated in the Second Affiliated Hospital of Xi’an Medical University from October 2016 to October 2017 were randomly divided into four groups according to the random number table:group A,group B,group C and group D,with 17 cases in each group.After induction of anesthesia,group A was given 10 ml saline,group B 0.5 mg/kg esmolol,group C 1 mg/kg esmolol,and group D 1.5 mg/kg esmolol,to observed effects of different administration of esmolol on induction of anesthesia induced by thyroid surgery under neurological monitoring.Results(1)There was no significant difference in heart rate,systolic pressure and diastolic blood pressure among the four groups before induction.(2)In group A and group B,the values of heart rate 60,180 and 300 s after intubation were significantly increased(P<0.05).The heart rate of group C 180 s and 300 s after intubation was significantly higher than that after induction(P<0.05).After intubation 300 s,the heart rate of group D was higher than that after induction(P<0.05).(3)Heart rate at intubation,60 s and 180 s after induction in group C,D was lower than group A,while systolic pressure at intubation,60 s after induction in group C,D was lower than group A,both with significant differences(P<0.05).(4)In the four groups,the blood rheology after intubation was significantly higher than that after anesthesia induction(P<0.05).(5)There was significant differences in sinus bradycardia among the four groups(P<0.05).Esmolol after intubation was lower in intravenous atropine bradycardia patients with a heart rate than before intravenous atropine(P<0.05).Conclusion Esmolol can significantly inhibit abnormal reaction to anesthesia intubation cardiovascular thyroid surgery at different doses,it is worthy of attention.

关 键 词：监测 手术中 甲状腺切除术 麻醉 硬膜外 艾司洛尔 

分 类 号：R614[医药卫生—麻醉学]