艾司洛尔对腹腔镜胆囊切除术血流动力学及内分泌的影响

目的:探讨艾司洛尔对腹腔镜手术患者手术期间血流动力学及内分泌的影响。方法:30例全麻下腹腔镜手术患者被随机分为对照组(A组,n=15)和艾司洛尔组(B组,n=15),B组于诱导时经静脉推注艾司洛尔0.5mg/kg,气腹前给予艾司洛尔0.5mg/kg,然后以50μg/kg.m in-1速度持续输注。记录A组与B组患者气腹前(T1)、气腹10m in(T2)、20m in(T3)及放气后10m in(T4)、拔管后(T5)的心率(heart rate,HR)、收缩压(systolic b lood pressure,SBP)、舒张压(d iastolic b lood pressure,DBP)、平均动脉压(m ean arterial pressure,MAP)的改变,同时测定T1~T5血中儿茶酚胺和多巴胺的浓度。结果:A组气腹期间相应时点的SBP、DBP、MAP比T1明显升高(P<0.01);T3时A组儿茶酚胺、多巴胺比T1明显增高(P<0.01),B组上述指标相应时点与T1相比无明显改变。结论:艾司洛尔能很好地稳定气腹引起的血流动力学及内分泌的变化,维持内环境稳定,同时可减少吸入异氟醚最低肺泡有效浓度,缩短拔管时间。

Effects of esmolol on hemodynamics and endocrine in patients undergoing laparoscopic cholecystectomy

Objective:To explore effects of esmolol on hemodynamics and endocrine in patients undergoing laparoscopic cholecystectomy(LC).Methods:30 patients undergoing elective LC in general anesthesia were randomly divided into control group(group A,n=15) and esmolol group(group B,n=15).Group B received esmolol 0.5mg/kg when anesthesia induction,esmolol 0.5mg/kg before pneumoperitoneum,then continuous infusion by velocity of 50μg/kg·min-1.The changes of HR,SBP,DBP,MAP at T1(before pneumoperitoneum),T2(10min after pneumoperitoneum),T3(20min after pneumoperitoneum),T4(10min after deflation) and T5(after decannulation) in 2 groups were recorded.Blood catecholamine and dopamine concentration in T1-T5 were measured.Results:In group A,SBP,DBP,MAP in T2-T5 increased significantly against T1(P<0.01),catecholamine and dopamine in T3 increased significantly against T1(P<0.01).All parameters didn' t significantly change in group B.Conclusions:Esmolol can maintain homeostasis,the hemodynamics and endocrine index during pneumoperitoneum,decrease minimum alveolar concentration value of Isoflurane inhalation and shorten the decannulation time.