依托咪酯在心血管患者麻醉诱导中的应用效果评价

目的探讨不同用法的依托咪酯对心血管麻醉诱导患者的血流动力学的影响。方法选择本院收治的360例冠心病搭桥手术患者,并随机分成A组和B组。A组先给予0.3mg/kg依托咪酯,而后依次静脉注射0.1mg/kg力月西、0.1mg/kg哌库溴铵、5μg/kg芬太尼;B组先静脉注射0.1mg/kg力月西、0.1mg/kg哌库溴铵及5μg/kg芬太尼,5min后再静脉注射0.3mg/kg依托咪酯。2组均于6min时行气管插管,并比较2组麻醉效果。结果 2组患者麻醉诱导后平均动脉压（MAP）明显下降,插管后MAP均开始上升,但A组患者插管前后MAP差异有统计学意义（P〈0.05）,B组插管前后MAP差异无统计学意义（P〉0.05）;整个麻醉诱导过程中,2组患者心率（HR）与动脉血氧饱和度（SpO2）均无明显变化。结论依托咪酯在心血管患者麻醉诱导中能发挥较好的麻醉效果,麻醉诱导过程中后期注射依托咪酯对患者血压波动影响较小,更适用于心血管患者的临床麻醉手术。

Effect of etomidate on induction of anesthesia in patients with cardiovascular disease

Objective To explore the influence of etomidate on hemodynamics in cardiovascular patient with induction of anesthesia. Methods 360 patients with coronary artery bypass surgery were randomly divided into groupA and group B. The groupA was treated with 0.3 mg/kg etomidate, intravenous injection of 0.1mg/kg liyuexi, 0.1 mg/kg piperazine rocuronium and 5μg/kg fentanyl respectively. The group B was treated with intravenous injection of 0.1 mg/kg liyuexi,0.1 mg/kg piperazine rocuronium, 5μg/kg fentanyl and 0.3 mg/kg etomidate respectively. Both groups were treated with endotracheal intubation at the time of 6 minutes, and anesthesia efficacy was compare between two groups. Results After induction of anesthesia, MAP decreased significantly in both groups, and then MAP increased after intubation. There was significant difference of MAP level before and after intubation in group A（P 0.05）. During the whole process of induction of anesthesia, there were no significant changes of SpO2and HR in both groups. Conclusion Etomidate plays a good anesthetic efficacy in cardiovascular patients with induction of anesthesia.Injection of etomidate in the middle and final stagesof induction of anesthesia is proved to be lessinfluence on the blood pressure of patients, and it is more suitable for clinical anesthesia in patients with cardiovascular disease.