摘要
目的为在气管插管时减轻心血管应激反应和维持血流动力学稳定，选出尼卡地平的理想剂量。方法４５例（ＡＳＡ－Ⅰ、Ⅱ）乳腺肿瘤切除病人随机分为 ３组，每组 １５例。在喉镜窥视前 ３ｍｉｎ，分别静注生理盐水 １０ｍｌ（组Ⅰ）或厄卡地平１５μｇ·ｋｇ－１（组Ⅱ）或３０μｇ·ｋｇ－１（组Ⅲ），麻醉诱导药为：芬太尼２．０μｇ·ｋｇ－１、异丙酚１．５ｍｇ·ｋｇ－１（不少于３０ｓ）。气管插管一次完成。记录麻醉前（Ｔ０），静注尼卡地平或生理盐水后２ｍｉｎ，静注琥珀胆碱前（Ｔ１）、插管后即刻（Ｔ２）、插管后３ｍｉｎ（Ｔ３）、５ｍｉｎ（Ｔ４）、１０ｍｉｎ（Ｔ５）所测定的平均动脉压（ＭＡＰ）和心率（ＨＲ）。结果①组Ⅱ和组Ⅲ的ＭＡＰ在静注尼卡地平后Ｔ１比麻醉前Ｔ０均有明显下降（Ｐ＜０．０５；Ｐ＜０．０１），其中，组Ⅲ的ＭＡＰ比组Ⅱ下降明显（Ｐ＜０．０５）。此期，组Ⅱ和组Ⅲ的ＨＲ均有显著增加（Ｐ＜０．０５；Ｐ＜０．０１），其中，组Ⅲ的ＨＲ比组Ⅱ增加更显著（Ｐ＜０．０１）。②组Ⅱ和组Ⅲ的ＭＡＰ在插管后Ｔ２与麻醉前Ｔ０比较，无显著差异。组Ⅰ的ＭＡＰ升高显著（Ｐ＜０．０１）。其中，组Ⅱ和组Ⅲ与组Ⅰ比较差异显著（Ｐ＜０．０１）。结论静注尼卡地平１５μ?
Objective To determine the optical dose of nicardipine(N) for the hemodynamic stability and less cardiovascular stress response during the pre - postintubation period. Methods Forty-five patients(ASA - Ⅰ, Ⅱ) undergoing excision of bed tumor were randomly divided into three group: group Ⅰ (normal saline), group Ⅱ (N15μg/kg), group Ⅲ (N30μg/kg). The medicine was given intravenously(iv) 3 minutes before laryngoscopy, then the inducement with 1. 5mg/kg propofol iv and 2. 0μg/kg fentanyl was administered. And systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (Map), heart rate (HR) and the-pressure product (RPP) were recorded respectively from 10 min before tracheal intubation to 10 min after tracheal intubation. Results ①The MAP of group Ⅱ and group Ⅲ before laryngoscopy decreased significantly than preinducement (P < 0.05, P < 0.01 ). The decrease of the blood pressure in group Ⅲ was more significantly than group Ⅱ. ②The increase of the MAP in both group Ⅱ and group Ⅲ after intubation was not significantly than preinducement. The increase of the MAP in control group was more significantly than both group Ⅱ and group Ⅲ (P < 0.01). Conclusion The calcium-channel blocker, nicardipine (15μg/kg intravenously 3 min before tracheal intubation) can decrease the response of tracheal intubation and prevent from low blood pressure.
出处
《哈尔滨医科大学学报》
CAS
2000年第4期283-285,共3页
Journal of Harbin Medical University
关键词
气管插管
尼卡地平
围麻醉期
血流动力学
tracheal intubation
nicardipine
cardiovascular stress response
hemodynamic stability
