咪唑安定分别与依托咪酯、异丙酚联合诱导时心血管反应的比较

目的:观察依托咪酯、异丙酚两种全身麻醉诱导药与咪唑安定联合诱导时对心血管反应。方法:选择80例ASAⅠ～Ⅱ级全身麻醉手术患者,开放外周静脉,随机均分为依托咪酯加咪唑安定组(A组)和异丙酚加咪唑安定组(B组),两组均加用芬太尼、维库溴铵复合麻醉诱导,经口明视气管插管,插管后麻醉机控制呼吸,潮气量8ml/kg,呼吸频率12bpm。用监护仪监测插管后1min、3min、5mio时收缩压(SBp)、舒张压(DBp)、平均动脉压(MAP)、心率(HR)的变化。结果:A组麻醉诱导后SBp、DBp、MAP、HR与诱导前相比,差异无统计学意义(P>0.05),而B组麻醉诱导后SBp、DBp、MAP、HR与诱导前相比明显降低,差异有统计学意义(P<0.01)。结论:异丙酚全身麻醉诱导后对血压、心率的抑制作用比较大,而依托咪酯对血流动力学影响则比较平稳。

Comparison of cardiovascular responses to inducement of midazolam combined respectively with etomidate and propofol

Objective To observe the cardiovascular responses to the inducement of midazolam combined respectively with etomidate and propofol.Method Total 80 ASA grade I ～ II patients with general anesthesia and open outer vein were selected and randomly divided into groups of etomidate with midazolam（group A） and propofol with midazolam（group B）.The two groups were both induced with the anesthesia of fentanyl and vecuronium combination.After the intubation through windpipe from the mouth breath was controlled by anesthesia machine with 8ml/kg humidity and 12bpm breath frequency.A monitor was used to observe the changes of SBp,DBp,MAP and HR 1 min, 3 min and 5 min after the intubation.Results There was no significant changes of SBp,DBp,MAP and HR in group A before and after the anesthesia inducement（P〉 0.05）,while in group B there was a significant decrease of SBp,DBp,MAP and HR after the anesthesia inducement（P〈 0.01）.Conclusion The inducement of propofol general anesthesia had much restraining effect on blood pressure and rhythm of the heart,while etomidate has a smooth and steady effect on blood flow dynamics.