依托咪酯在高龄心脏病患者非心脏手术麻醉诱导中的应用

目的对比观察依托咪酯与咪唑安定在高龄心脏病患者行非心脏手术麻醉诱导中对血流动力学的影响。方法选择36例患者，随机均分为两组。治疗组以乳剂依托咪酯复合芬太尼诱导，对照组以咪唑安定复合芬太尼诱导，分别记录诱导前、用药后3min、插管前和插管后3min的心率（HR）、收缩压（SBP）和舒张压（DBP）变化。结果麻醉诱导给药3min后，对照组HR，SBP，DBP与麻醉诱导前相比均有明显下降（P〈0．01），且SBP及DBP下降幅度明显大于治疗组（P〈0．051；插管后3min，SBP及DBP均未恢复正常，与诱导前相比仍有明显下降（P〈0.05）。治疗组仅在插管时HR，SBP和DBP有短暂下降（P〈0．05）：插管后3min，HR，SBP，DBP均恢复接近正常（P〉0．05）。结论乳剂依托咪酯复合芬太尼进行麻醉诱导，对高龄心脏病患者的血流动力学影响轻微，行非心脏手术时较咪唑安定更安全、平稳。

Effects of Anesthesia Induction with Etomidate and Midazolam on Circulation System of Geriatric Patients with Heart Diseases for Noncardiac Surgery

Objective To observe the effects of anesthesia induction with etomidate and midazolam on hemodynamics of the geriatric patients with heart diseases for noncardiac surgery. Methods Thirty- six geriatric patients with heart diseases for noncardiac surgery were randomly divided into group Ⅰ （anesthesia induction with etomidate, 18 cases） and group Ⅱ （anesthesia induction with midazolam, 18 cases）,the change of hear rate （HR）,systolic blood pressure （SBP）,diastolic blood pressure （DBP） were recorded during anesthesia induction with etomidate or midazolam respectively. Results HR,SBP and DBP were all decreased remarkably in group H after midazolam i.v. for 3 min （P 〈 0.01）,and were still lower even when the intubation was finished for 3 min. In group Ⅰ,HR,SBP and DBP were all decreased only when the intubation was begun （P 〈0. 05）,and returned to normal after the intubation was finished for 3 min. The change of HR, SBP and DBP during induction in group Ⅱ were more obvious than those in group Ⅰ （P 〈0. 05）. Conclusion Etomidate is better than midazolam for anesthesia induction,whlch has little interference in hemodynamics of geriatric patients with heart diseases for noncardiac surgey.