扩容和麻黄碱对老年病人全麻诱导期循环功能的影响

目的 讨论使用预先扩容或麻黄碱对老年手术病人全麻诱导期对低血压和低心输出量的预防作用.方法 将90位ASAⅠ～Ⅱ级65岁以上老年患者随机分为三组:对照组(n=30),诱导时不给麻黄碱或扩容;麻黄碱组(n=30):麻醉诱导前给予麻黄碱;扩容组(n=30):诱导前给予羟乙基淀粉扩容.观察患者入室时(T1)、诱导后1 min...

Effect of preoperation volume expansion and ephedrine on cardiovascular response of the elders during induction of general anesthesia

Aim To study the effect of ephedrine and preoperation volume expansion on preventing the decrease of arterial pressure and cardiac output during induction of general anesthesia in the elders.Methods Ninty ASA I~Ⅱ patients older than 65 were divided randomly into three groups with thirty patients in each group：control group（group C）,ephedrine group（group E）,volume expansion group（group V）.In group C,nothing else was given before or during the induction of anesthesia;In group E,ephedrine 0.1 mg·ml-1 was given before induction of anesthesia;In group V,6% hydroxyethyl-starch（HES）10 ml·kg-1 was infused before induction of anesthesia.Systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,cardiac output（CO）,centre venous pressure（CVP）were monitored in different periods.Results SBP and DBP decreased significantly after induction in group C（P0.05）.The degree of decreasing in group E is smaller than that in group C（P0.05）.The decrease of SBP and DBP after induction in group V is not so significant as the other two groups.BP increased after intubation in all the groups（P0.05）.And the SBP in group E was higher than the other two groups（P0.05）.Then the SBP in group C decreased significantly while the SBP of other two groups maintained at the baseline level.CO decreased significantly both in group C and group E（P0.05）.There were no differences between the two groups.CO in group V did not change.HR increased after intubation in all groups and group E became higher than group C and group V（P0.01）.Conclusion 0.1 mg·kg-1 of ephedrine can prevent the decrease of BP after induction,but cannot prevent the decrease of CO.Volume expansion with 10 ml·kg-1 of HES can prevent the decrease of BP and CO after induction.