摘要
目的观察麻醉诱导前单次静脉注射两种剂量的艾司洛尔预防气管插管心血管反应的临床效果及安全性。方法对20所医院共1830例全麻气管内插管病人于全麻诱导前随机分为静脉注射盐酸艾司洛尔1mg／kg组（E1组）及2mg／kg组（E2组），对照组注射生理盐水（E0组），观察全麻诱导后及插管后1～10分钟心率、收缩压、舒张压和平均动脉压变化及不良反应。结果诱导后及插管后E0组病人心率及平均动脉压明显高于E1组和E2组（P＜0．05～0．01），E1组病人心率快于E2组（P＜0．05～0．01）；E0组病人心动过速发生率为63．8％，E1组为34．7％，E2组为22．6％，后两组与E0组比较P＜0．01。E1、E2组病人低血压和心动过缓的发生率分别为18．8％、21．0％、11．5％、11．3％；E0组病人低血压和心动过缓的发生率分别为12．3％、5．2％，均P＜0．01。未出现严重的心血管毒副作用。结论单次静脉注射1～2mg／kg的盐酸艾司洛尔预防气管插管所致心血管反应安全有效，临床效果和副作用与用药剂量有关。
Objective To explore the dose-response relation and the safety of esmolol administered as a single iv bolus prior to the induction of anesthesia for preventing the haemodynamic response to tracheal intubation.Methods 1830 patients from 20 centres were randomly divided into three groups: E1 group, receiving esmolol at a dose of 1 mg/kg; E2 group, at 2 mg/kg and E0 group, receiving 0.9% NaCl. Heart rate, systolic and diastolic, and mean artery blood pressures (MAP) were measured following the induction and 1 to 10 minutes following the intubation. Results The patients in the E0 group had greater HR and MAP values after anesthesia induction and tracheal intubation than the patients in the E1 and E2 groups (P < 0.05 ~ 0.01 ). The E1 group had higher HR than the E2 group (P < 0.05 ~ 0.01 ). The incidence of tachycardia after intubation was higher in the E0 group (63.8%)than in the E1 group (34.7%) and the E2 group (22.6%) (P< 0.01). The proportion of hypotention and bradycardia was higher in the two treatment groups than the E0 group (P < 0.01), but no severe adverse event was observed. Conclusion A 1 ~ 2 mg/kg bolus of esmolol is effective and safe for preventing the haemodynamic response to tracheal intubation. The clinical and side-effects are all dose-related.
出处
《中华医学杂志》
CAS
CSCD
北大核心
1999年第11期828-831,共4页
National Medical Journal of China
关键词
全身麻醉
气管内插管
心血管反应
艾司洛尔
Adrenergic beta-antagonists
Anesthesia,general
Intratracheal
Cardiovascular system
