甲氧明联合阿托品预防老年患者全麻诱导期低血压的临床观察

目的:观察临床应用甲氧明联合阿托品在老年患者全麻诱导期血流动力学的变化。方法:选择ASAⅠ～Ⅱ级择期行全麻腹腔镜胆囊切除术患者90例,随机分成3组,每组30例,Ⅰ组作为对照组常规诱导,其余两组分别在全麻诱导时稀释后静脉缓慢推注甲氧明2mg(Ⅱ组)和阿托品0.5mg+甲氧明2mg(Ⅲ组)。三组中当收缩压下降超过基础值的20%时追加麻黄素10mg。记录诱导前基础值和诱导后1min,3min,5min各组患者收缩压,舒张压,心率的值及麻黄素追加的例数。结果:与基础值比较,Ⅰ组收缩压,舒张压和心率有明显变化(P<0.05),麻黄素的追加次数明显超过Ⅱ组和Ⅲ组(P<0.05);Ⅱ组收缩压,舒张压无明显统计学差异(P>0.05),心率有明显变化(P<0.05);Ⅲ组收缩压,舒张压及心率均无明显统计学差异(P>0.05)。结论:甲氧明能有效地降低低血压的发生,阿托品能够预防心率减慢,甲氧明与阿托品联合应用使老年患者全麻诱导期血流动力学更加稳定。

Preventive effects of methoxamine combing with ephedrine on hypotension following induction of anesthesia in elderly patients

Objective: To investigate the clinical effects of the combined application of methoxamine and atropine on hemodynamic changes during induction period anesthesia in elderly patients.Methods:A total of 90 cases(among 65 to 70-year-old,ASA I ~ II) scheduled for selective laparoscopic cholecystectomy were randomly divided into three groups with 30 cases in each group.Group Ⅰserved as control group(conventional induction of anesthesia),group II were administered with diluted methoxamine(2 mg) during induction period,and group Ⅲ was given methoxamine(2 mg) + atropine(0.5 mg).Additional ephedrine(10 mg) was administered when the systolic blood pressure dropped by more than 20%.The baseline values of systolic blood pressure,diastolic blood pressure,heart rate value as well as those values 1 min,3 min,5 min after induction and additional use of ephedrine were observed.Results:Comparing with baseline values,the systolic pressure,diastolic blood pressure and heart rate in group Ⅰwere significantly changed(P<0.05),the use of additional ephedrine was significantly more frequent than the other two groups(P<0.05);heart rate of group II showed significant changes(P<0.05) after induction while the systolic pressure,diastolic blood pressure maintained well(P>0.05).No significant differences in systolic pressure,diastolic blood pressure and heart rate were found in group III(P>0.05).Conclusions:Methoxamine can effectively reduce the incidence of hypotension,atropine can prevent occurrence of slow heart rate.While combined use of methoxamine and atropine during induction of general anesthesia in elderly patients could maintain stable hemodynamics.