静脉注射利多卡因对老年冠心病非心脏手术围插管期心率变异性的影响

目的：研究静脉注射利多卡因在全麻诱导气管插管期间对老年冠心病自主神经系统功能的影响。方法：选择90例择期腹部手术老年冠心病患者．随机分成利多卡因组（L组n=45）和安慰剂组（P组n=45）．分别于麻醉前（T0），麻醉诱导后（T1）及气管插管后（T2）用心率变异功率谱分析（HRPSA）技术观察患者的心率变异性（HRV）改变。结果：麻醉诱导后．两组HRV总功率频段（TP）和其中低频段（LF），高频段（HF）．LF／HF（低频／高频比）均显著降低（P〈0．05）．组间比较L组LF低于C组（P〈0．05）；气管插管后，两组LF、HF、LF／HF及TP均显著升高（P〈0．05）．组间比较L组LF与LF／HF升高程度显著低于P组（P〈0．05），HF组间差异无统计意义。结论：静注利多卡因能明显抑制插管操作引起植物神经功能的干扰．有利于维护老年冠心病患围插管期心脏自主神经调节功能。

Heart Rate Variability during Intubation under Intravenous Injection of Lidocaine General Anesthesia with Elderly Heart Disease Patients in Non-cardiac Surgery

Objective： Research Intravenous injection of lidocaine in the whole intubation during the induction of elderly coronary heart disease autonomic nervous system function. Methods： 90 patients undergoing abdominal surgery patients with coronary heart disease, Were randomly divided into lidocaine group（L group, n=45） and placabo group （P group, n=45）, In pre-anesthesia （T0）, after the induction of anesthesia （T1） and after intubation （T2） With power spectral analysis of heart rate variability （HRPSA） observed in patients with heart rate variability （HRV） changes. Results： After induction of anesthesia, two groups of a total power of HRV spectrum （TP） and one of low-frequency （LF）, high frequency （HF）, LF / HF （low frequency / high frequency ratio） were significantly lower （P 〈0.05）, inter-group comparison L group LF lower than P group （P 〈0.05）; After tracheal intubation, two groups of LF, HF, LF / HF and TP were significantly higher （P 〈0.05）, inter-group comparison Group L with LF / HF increased significantly lower than the P group （P 〈0.05）, HF inter-group difference was not significant. Conclusion： Intravenous lidocaine could inhibit the intubation operation caused by interference with autonomic function, be beneficial to maintain cardiac autonomic nerve function to old patients with coronary artery disease during intubation.