艾司洛尔控制氯胺酮心血管反应的效果观察  

Effects of Esmolol on Cardiovascular Response of Ketamine

作　　者：胡旭东[1] 吴亚彬[1] 刘幸清[1] 唐兴祥[1] 何仁亮[1] 

机构地区：[1]广东省佛山市第一人民医院,广东佛山528000

出　　处：《海南医学》2004年第6期7-8,共2页Hainan Medical Journal

摘　　要：目的 观察艾司洛尔控制氯胺酮心血管反应的临床效果。方法 选择 32例ASAⅠ级,年龄6—12岁的儿童,随机分为观察组和对照组(n=16)。用静脉注射氯胺酮1mg/kg行麻醉诱导,以2.5mg/kg/h持续注入维持麻醉。观察组在麻醉诱导前静注艾司洛尔0.5mg/kg,然后以0.1mg/kg/min维持。对照组不用艾司洛尔。监测并记录诱导前(T_0)、诱导后2分钟(T_1)、5分钟(T_2)和手术开始后5分钟(T_3)不同时点的HR和平均动脉压(MAP)。结果 对照组静注氯胺酮后各时点HE和MAP均比基础值T_0显著增加(P<0.05),而观察组静注氯胺酮后HR和MAP均无明显变化(P>0.05);两组间比较,在T_1、T_2、T_3三个时点,观察组的MAP和HR均明显低于对照组(p<0.05)。结论 艾司洛尔可有效地控制氯胺酮的血压升高和心率增快反应,维持病人循环稳定。Objective: To observe the clinical effects of esmolol on cardiovascular response of ketamine. Methods: 32 children with ASA status Ⅰ scheduled for selected surgery under ketamine general anesthesia were divided into two groups: control group and study group (n=16). Anesthesia was induced with bolus of ketamine 1mg/Kg and maintain with the ketmine infusion at the rate of 2.5mg/kg/h in all children. In study group, a bolus of esmolol 1mg/Kg was administrated intravenously before anesthesia induction, then the infusion of esmolol at the rate of 0.1mg/kg/min was maintained. And in control group, any esmolol was not administrated. The MAP and HR were monitored and recorded before the anesthesia induction(T0), at 2 min(T1) and 5min (T2)after the anesthesia induction, and at 5min after the beginning of surgery (T3). Results: At the measure points of T1, T2 and T3 after the ketamine administration, the HR and MAP in control group increased significantly compared with T0 (p<0.05); the HR and MAP did not changed significantly in study group (p> 0.05); When compared between the two groups, At the measure points of T1, T2 and T3, the HR and MAP in study group were lower than those in control group (p<0.05). Conclusion: The administration of esmolol can effectively attenuate the cardiovascular response of ketamine, such as the increase of the blood pressure and the heart rate and keep the circulation of the children steady during ketamine adiministration.

关 键 词：艾司洛尔 氯胺酮 心血管反应 血药浓度 

分 类 号：R54[医药卫生—心血管疾病]