不同剂量国产依托咪酯用于青年患者麻醉诱导时对血流动力学的影响

目的: 观察和比较不同剂量依托咪酯用于青年患者麻醉诱导时血流动力学的变化及不良反应。方法: 选择20~45岁择期全麻手术患者80例,按照诱导药物和剂量随机分为4组,每组各20例。P组以异丙酚2mg·kg^-1诱导,E₄、E₅、E₆分别以依托咪酯0.4,0.5,0.6mg·kg^-1诱导。观察并记录4组患者诱导前(T₀)、气管插管前(T₁)、气管插管即刻(T₂)、插管后1min(T₃)、插管后3min(T₄)、插管后5min(T₅)各组的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)的变化,以及不良反应。结果: 与T₀比较,P组、E₆组诱导后患者SBP、MAP显著下降(P<0.01),E₄组插管后患者SBP、DBP、MAP明显上升(P<0.05),E₅组患者各指标一直平稳(P>0.05)。与P组比较,E₆组患者T₃至T₅时点DBP、MAP明显低于P组(P<0.05),E₄组、E₅组患者T₁时点SBP、DBP、MAP明显高于P组(P<0.05)。结论: 依托咪酯0.5mg·kg^-1适合青年患者全麻诱导,血流动力学变化平稳,插管应激反应低。

Effects of different doses of domestic etomidate on hemodynamics during anesthesia induction in young patients

OBJECTIVE To observe and compare hemodynamic changes and adverse reactions at different doses of etomidate during anesthesia induction for young patients. METHODS Eighty general anesthesia patients (20 to 45 years old ) were divided into four groups according to induced drugs and different doses.Propofol 2 mg·kg^-1 was given in group P,etomidate 0.4 mg·kg^-1,0.5 mg·kg^-1 and 0.6 mg·kg^-1 were given respectively in group E₄,E₅ and E₆.Changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),mean arterial pressure (MAP),heart rate (HR) and adverse reactions were observed and recorded before induction (T₀),before tracheal intubation (T₁),at the moment just before intubation (T₂),at 1min (T₃),3 min (T₄) and 5 min (T₅) after intubation. RESULTS Compared with T₀,SBP and MAP were significantly decreased in group E₆ and P (P<0.01),SBP,DBP and MAP were significantly increased after intubation in group E₄ (P<0.05),while indexes of group E₅ were stable (P>0.05).DBP and MAP were lower in group E₆ than in group P at T₃ to T₅ (P<0.05),SBP,DBP and MAP were higher in group E₄ and E₅ than in group P at T₁ (P<0.05). CONCLUSION Etomidate 0.5 mg·kg^-1 is suitable in attenuating intubation-induced stress response and maintaining stable hemodynamics for young patients during induction of anesthesia.