盐酸艾司洛尔对气管内插管应激反应的影响与给药时间的关系

目的：探讨盐酸艾司洛尔（ESM）用于预防气管内插管应激反应的临床效应。方法：选择胸、腹及下肢择期全麻手术者60例，按先后顺序随机将病例分成A、B、C三组，每组20例。A组诱导前静注ESM1．5mg/kg,1min注完；B组ESM改诱导后静注，注完后立即气管内插管、C组用同容量生理盐水代替ESM，三组诱导用药相同。结果：A、B组收缩压（SDP）、舒张压（DBP）、平均动脉压（MAP）及心率（HR）除插后即刻高于（P＜0．05）术前基础值外，插管后1、5、10min以上各参数与基础值基本接近，而C组SDP、DBP、MAP及HR插管后即刻明显高于（P＜0．01）术前基础值，插管后5min以上各参数仍高于术前基础值（P＜0．05），且插管反应较A、B两组剧烈。A组窦缓发生率明显高于B组（P＜0．05）。结论：ESM对预防气管内插管的应激反应有一定的预防作用，但不足以完全抑制气管内插管的应激反应。将ESM诱导后用药能有效地减少窦缓的发生。

EFFECT OF ESMOLOL ON CIRCULATORY STRESS REACTION DU RING TRACHEAL INTUBATION WITH THE TIME OF INTRAVENOUS ADMINISTRATION

Objective:To investigate the effect of esmolol on circulatory response during tracheal intubation.Methods:Sixty adult patients scheduled for selective surgery in general anesthesia were randomly divided into three groups,A,B,and C(n=20).Group A,esmolol(ESM)1 5 mg/kg iv before induction;Group B,ESM 1 5 mg/kg iv after induction;Group C,0 9%NS iv before induction.Results:SBP,DBP,MAP,and HR remained unchangcd 1,5,10 min after endotracheal intubation in groups A and B,and increased immediately after intubation in group C( P <0 01).HR in group A decreased significantly ( P <0 05) as compared with that in group B.Conclusion:Intravenous administration of esmolol before endotracheal intubation could attenuate cardiovascular response,but could not depress the stress reaction completely.Intravenons administration of esmolol after induction could attenuate bradycardia.