丙泊酚、利多卡因和艾司洛尔对气管插管期间心血管反应的影响

目的探讨丙泊酚、利多卡因和艾司洛尔对气管插管期间心血管反应的影响。方法选择60例全麻手术患者,随机分为3组,每组20例。A组(丙泊酚组):气管插管前30 s静脉注射丙泊酚0.5 mg/kg;B组(利多卡因组):苯璜酸阿曲库铵静脉注射后2%利多卡因3 ml气管内表面麻醉;C组(艾司洛尔组):气管插管前30 s静脉注射艾司洛尔0.5 mg/kg。诱导方法:依次静脉注射咪达唑仑0.03 mg/kg、枸橼酸芬太尼3μg/kg、丙泊酚2 mg/kg、苯璜酸阿曲库铵0.8 mg/kg。3组均于苯璜酸阿曲库铵静脉注射后4 min插管。观察指标:记录MAP、HR在麻醉前、插管后1、3、5 min的变化。结果 3组MAP与T0相比,在T1均较稳定(P>0.05)、在T2、T3显著下降(P<0.01);A组HR比较B组、C组,在T1、T2明显升高(P<0.05);B组HR比较T0,在T1、T2较稳定(P>0.05);C组HR比较T0,在T1较稳定(P>0.05)、在T2明显下降(P<0.05)。结论利多卡因和艾司洛尔均可减轻患者气管插管时的心血管反应,艾司洛尔更佳。

Effects of propofol, lidocaine and esmolol on cardiovascular response during intubation

Objective To investigate the effects of propofol,lidocaine and esmolol on cardiovascular response during intu- bation. Methods 60 patients of general anesthesia were randomly divided into 3 groups, with 20 cases each. Group A （ group of propofol ） received intravenous injection of 0.5 mg/kg propofol 30 seconds before intubation; Group B （ group of lidocaine） received tracheal surface anesthesia with 2% lidocaine after intravenous injection of atracurium and Group C （ group of esmo- lol） received intravenous injection of 0.5mg/kg esmolol 50 seconds before intubation. Tracheal intubation was performed with midazolam 0.03mg/kg, fentanyl 3 txg,/kg, propofol 2mg/kg and atracurium 0.8mg/kg. The 3 groups were intubated four mi- nutes after intravenous injection of atracurium. The vital signs MAP, HR） during intubation were recorded. Results Compared with TO in all the 3 groups, MAP in T1 was steady （ P 〉 0.05 ） and decreased significantly in T2 and T3 （ P 〈 0.01 ） ; HR in group A, when compared with group B and group C,was higher in T1 and T2 （P 〈0. 05） ;HR in group B, in contrast with TO, was steady in T1 and T2 （ P 〉 0.05 ） ; HR in group C was steady in T1 compared with TO. （ P 〉 0.05） but lower in T2 （ P 〈 0.05 ）. Conclusion Both lidocaine and esmolol can reduce cardiovascular response to tracheal intubation , while esmolol is better in effect.