利多卡因和艾司洛尔预防七氟醚诱导插管反应的研究

目的 比较在单纯吸入七氟醚诱导插管期间,利多卡因和艾司洛尔对患者心血管反应的影响.方法 选择全麻下行择期非心脏手术患者60例,ASA分级Ⅰ～Ⅲ,年龄20～65岁,随机分为3组(n=20); Ⅰ组(对照组),Ⅱ组(艾司洛尔组),Ⅲ组(利多卡因组).麻醉诱导前2 min,Ⅰ组静脉注射生理盐水1 ml,Ⅱ组静脉注射艾司洛尔2 mg/kg,Ⅲ组静脉注射利多卡因1.5 mg/kg.然后进行麻醉诱导插管,在插管过程中连续监测患者血压(SBP,DBP)和心率(HR).记录麻醉诱导前(T0基础值),气管插管即刻(T1),气管插管后即刻(T2),1 min(T3),3 min(T4),5 min(T5)时上述指标.结果 Ⅲ组患者的SBP,DBP较Ⅰ组低,但心率增加与Ⅰ组无差异,Ⅱ组患者的SBP,DBP andHR与Ⅰ组相比均明显降低.结论 利多卡因能够抑制七氟醚麻醉诱导插管期间血压升高,但不能有效抑制心率增快.艾司洛尔对血压、心率的升高均有明显抑制作用.

The research of the effects of lidocaine and esmolol on cardiovascular response to tracheal intubation in patients during induction of anaesthesia with sevoflurane

Objective To compare the effects of lidocaine and esmolol on cardiovascular response to tracheal intubation in patients during induction of anesthesia with sevoflurane.Methods Sixty ASA ⅠorⅡ patients aged 20~65 years undergoing uncardic operation under sevoflurane anesthesia were randomly divided into 3 groups(a=20):Ⅰ(control group),Ⅱ(esmolol group),Ⅲ(lidocaine group).2 min before induction,NS1 ml was injected IV inⅠgroup,esmolol 2 mg/kg was injected IV inⅡgroup and lidocaine 1.5 mg/kg was injected IV in Ⅲgroup.Then tracheal intubation was performed.BP(SBP,DBP),and HR were continuously monitoted during anesthesia and recordede immediately before induction(T0,baseline),immediately before intubation(T1),immediately after intubation(T2) and 1,2,3 min after intubation(T3、T4、T5).Results SBP,DBP decreased significantly in Ⅲgroup as compared toⅠgroup.and SBP,DBP and HR decreased more significantly inⅡgroup.Conclusion Both lidocaine and esmolol can inhibit the cardiovascular response to tracheal intubation in patients during induction of anesthesia with sevoflurane.The effects of esmolol is more significant.