阿托品对胆囊切除术心率变异性的影响

目的 观察腹腔镜胆囊切除时心率变异性(HRV)变化及阿托品预防心动过缓时对HRV的影响。方法 21例胆囊切除术病人按术前心电图诊断分为心动过缓组和非心动过缓组,心动过缓病人麻醉诱导前加用阿托品0.5mg,术中监测HRV和心率。结果 两组病人胆囊切除中低频率/高频率(LF/HF)均显著低于术前基础值(P<0.05)。心动过缓组诱导后HF无明显变化,胆囊切除中显著降低(P<0.01);非心动过缓组则显著升高(P<0.01)。结论 胆囊切除术中,心动过缓者预防性使用阿托品可阻止迷走神经兴奋性增加,但并不能恢复植物神经系统的平衡。

Effects of atropine on heart rate variability during laparoscopic cholecystectomy

Objective To investigate the change of heart rate variability(HRV) and effect of prophylactic atropine on HRV during laparoscopic cholecystectomy. Methods Twenty-one patients undergoing laparoscopic cholecystectomy were divided into bradycardia group (n=11) and non-bradycardia group (n=10 ) according to the preoperative diagnosis of ECG. Patients in the bradycardia group received atropine 0.5 mg before induction of anesthesia. HRV and HR were then monitored. Results The low frequercy/high freqwency ( LF/HF) was lower significantly than the basic value during cholecystectomy in both groups. HF had no change after anesthesia induction, but was lower significantly than the basic value during cholecystectomy in the bradycardia group. HF increased significantly after anesthesia induction and during cholecystectomy in the non-bradycardia group. Conclusion Prophylactic atropine can decrease vagal excitability, but can't balance the autonomic system in bradycardia patients during cholecystectomy.