美托洛尔预防老年围拔管期心血管反应的临床观察

目的探讨美托洛尔用于预防老年患者围拔管期心血管反应的方法。方法40例全身麻醉行择期手术的老年患者随机分为A组20例,B组20例,A组围拔管期分次静注美托洛尔0.06~0.1 m g/kg,B组以生理盐水分次静注。观察手术结束时、拔管前5分钟、拔管时、拔管后5、20分钟的心率(HR)、收缩压(SBP)、舒张压(DBP)及心率收缩压乘积(RPP)的变化。结果A组拔管时、拔管后5、20分钟的HR、RPP与手术结束时比较,差异无统计学意义,用药后最慢心率53次/m in,围拔管期血压维持平稳,RPP保持在较低值;B组拔管前5分钟、拔管时、拔管后5分钟的各参数与手术结束时比较明显升高(P<0.01);两组间比较,B组拔管前5分钟、拔管时、拔管后5分钟的HR、SBP、RPP明显高于A组(P<0.01)。结论老年患者小剂量分次静注美托洛尔可以安全地预防围拔管期心血管反应。

Clinical efficacy of metoprolol on cardiovascular responses of elderly patients during tracheal extubation

Objective To study the method of metoprolol injection for prevention of cardiovascular responses in elderly patients during tracheal extubation.Methods Forty elderly patients undergoing elective operation under general anesthesia were randomly divided into 2 groups with 20 patients in each group: the metoprolol group(A) and the control group(B).In Group A,metoprolol was injected intravenously for several times,with the total dose being 0.06mg/kg-0.1 mg/kg.In Group B,normal saline was given instead.HR,SBP,DBP and RPP(heart rate-systolic BP product) were observed at the points of the end of surgery,5 min before,during,and 5,20 min after extubation.Results In Group A,HR,RPP remained unchanged at tracheal extubation and 5,20 min after extubation,and the slowest HR was 53 bpm after metoprolol administration.BP remained unchanged and RPP kept in low values during tracheal extubation.In Group B,HR,SBP,DBP and RPP were significantly increased at 5 min before,during,and 5 min after extubation as compared with the values of the end of surgery(P<0.01).HR,SBP and RPP at every time points were significantly higher in Group B than Group A(P<0.01).Conclusion Metoprolol injected intravenously with a small dose for several times can safely prevent cardiovascular responses of elderly patients during tracheal extubation.