艾司洛尔复合异丙酚缓解气管插管时应激反应的剂量水平的调查分析

目的探讨非心脏手术患者应用艾司洛尔预防气管插管引起血流动力学变化的合理剂量水平。方法33例患者随机分为3组。T0组为对照组（11例），T1组为0．5mg／kg艾司洛尔组（11例），T2组为1mg／kg艾司洛尔组（11例）。静注异丙酚和维库溴铵诱导气管内捅管。监测捅管后1min、3min、5min及10min收缩胝、舒张压和心率（HR）；并抽取不同时间血标本用高压液相包谱仪测血浆中去甲肾上腺素（NE），肾上腺素（E）和多巴胺（DA）浓度。结果与基础值比，T0组插管后1min时血压和心率显著升高（P〈0．05或P〈0．01）。T1组插管后3min、5min及10min时血压和心牢显著降低（P〈0．01或P〈0．05）；3min及5min时去甲肾上腺以及。肾上腺素水平显著升高（P〈0．01或P〈0．05）。T2组心率、血压、去甲肾上腺素及。肾上腺素水平显著降低（P〈0．01或P〈0．05），与T1组比较，捅管后1min和3min时肾上腺素水平显著降低（P〈0．01）。结论1．0mg／kg艾司洛尔复合异丙酚可缓解插管时循环反应及儿茶酚胺反应。

Investigation on doses of esmoiol combined with propofoi to alleviate the stress response to endotracheal intnbation

Objective To investigate the reasonable doses of esmolol applied in non - cardiac surgery patients to prevent hemodynamie changes caused by endotraeheal intubation. Methods 33 patients were randomly divided into 3 groups. The T0 was the control group （ l 1 cases） ; esmolol 0. 5 mg/kg was administered to the T1 group （ 11 eases） ; esmolol 1 mg/kg was administered to the T2 group （ 11 cases）. Intravenous propofol and veeuronium were given to induce endotracheal intubation. The systolic： blood pressure （SP）, diastolic pressure （DP）and heart rate （HR） at 1 rain,3 min,5 rain, and 10 min after intubation were monitored ; also, the blood samples at different times were collected to measure norepinephrine （ NE）, epinephrine （E） and dopamine （DA） concentrations with the high -pressure liquid chromatograph. Results Cmnpared with the baseline, the blood pressure and heart rate in To group significantly increased （P 〈 0.05 or P 〈 0. 01 ） at 1 minute ＇after intubation. The blood pressure and heart rate in T1 group decreased signifieandy（ P 〈0. 01 or P 〈0. 05） at 3,5 and 10 minutes after intubation; meanwhile, the levels of noradrenaline and adrenaline markedly increased （P 〈 0. 01 or P 〈 0.05） at 3 and 5 minutes. The heart rate, blood pressure, norepinephrine and epinephrine levels in T2 group obviously redueed（P 〈 0. 01 or P 〈0. 05） ; moreover the adrenaline level significantly decreased （ P 〈0.01 ） at 1 and 3 minutes after intubation, compared with that of the T1 group. Conclusion Esmolol 1. 0 mg/kg combined with propofol could alleviate hemodynamie and cateeholamine responses to endotracheal incubation.