美托洛尔预防冠心病患者气管插管反应的效果观察

目的探讨美托洛尔预防冠心病患者气管插管反应的效果。方法60例非体外循环下行冠状动脉搭桥手术患者，随机分为2组。治疗组气管插管前5min静注美托洛尔50ug／kg，对照组静注等量生理盐水，观察两组患者诱导前，插管时（暴露声门时），插管后1min、3min、5min及10min共6个时点心率（HR）、平均动脉压（MAP）变化及插管期间发生的心律失常。结果治疗组MAP在插管前、后无明显变化，HR插管后一度上升，但仍低于诱导前（P〉0．05）；对照组插管时和插管后1min、3min、5min的MAP、HR均显著升高，与诱导前及治疗组相同时点比较差异有统计学意义（P〈0．01），随后与治疗组比较差异无统计学意义（P〉0．05）。插管期间对照组有3例发生室性早博。结论美托洛尔可有效减轻冠心病患者插管期心血管不良反应，减少心律失常的发生。

Effect of Metoprolol on intratracheal intubation response of patients with coronary artery disease

Objective To evaluate the effect of metoprolol to prevent the adverse reactions of intratracheal intubation of patients tmderwent off-pump coronary artery bypass graft （OPCAB）. Methods 60 cases underwent OPCAB were randomly divided into two groups, therapy group and control group. Therapy group received metoprolol 50 ug/kg by intravenous injection 5 minute before intratracbeal intubation, while control group received equivalent 0.9% NS by the same way at the same time. Observe mean artery pressure （MAP） and heart rate （HR） before induction, period of intubation, the point of time of 1,3,5,10 minute followed intubation. Results MAP of the therapy group changed slightly. And Hrof theapy group was lower than the control group ＂s （P〈0.05）. While the MAP and HR of the control group during induction, period of intubation, the point of time of 1,3,5,10 minute followed intubation, were significantly different from the ones before induction and the same time of therapy group （P〈0.01）. 3 cases ventricular premature contraction occurred in the control group. Conclusion Metoprolol can effectively decrease cardiovascular adverse reactions, especially the arrhythemia, during intratraeheal intubation for the patients undergo OPCAB.