静注艾司洛尔与利多卡因对抑制插管应激反应临床观察

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1、静注艾司洛尔与利多卡因对抑制插管应激反应临床观谢牛.春陈桂枝四川省绵阳市人民医院麻醉科四川绵阳621000目的：比较观察全麻病人气管插管前分別静脉给予艾司洛尔和利多卡因对于插管时的动脉血儿茶酚胺CA(去甲肾上腺素NE和肾上腺素E)浓度变化从而反映气管插管的应激反应变化。方法：50例病人随机分为两组，每组25例，I组为艾司洛尔组，II组利多卡因组。静注芬太尼2μg?kg-l,异丙酚2mg?kg-l,维库溴铵0.1mg?kg-l诱导插管。I组病人插管前2min，静脉给予艾司洛2mg/kg;ll组病人插管前2min静注利多卞•因lmg?kg-l，其余操作两组相同。从诱导时开始到

2、插管后lOmin连续记录SBP、DBP、HR指标并抽取相应时段动脉血液监测儿茶酚胺浓度的变化。结果：除I组病人在喉镜暴露即刻和插管后3min心率明显低于II组外(p<0.05),其它在插管前后血压、心率均无明显变化。而II组病人的儿茶酚胺浓度在插管即刻及插管后3min出现明显降低(p<0.05>与I组相比有显著性差异。结论：插管前静脉注射艾司洛尔不能抑制应激反应的产牛.，只能缓解由于儿茶酚胺释放引起的心血管反应；静注利多卡因能抑制应激反应的发生。【关键词】气管插管；艾司洛尔；利多卡因；应激反应；儿茶酚胺【1R614.2B1764-8999(2015)7-0562-0

3、2Clinicalobservationofesmololandlidocaineontheinhibitionofstressresponsestotrachealintubationxieshengchun,chenguizhiDepartmentofAnesthesiologyMianyangPeople'sHospitalofSichuanProvince621000【Abstract】Objective：Tocompareandobservepatientsbeforetrachealintubationwereinjectedesmololandlidocainer

4、espectivelyandextractedarterialbloodofthistimefordeterminationofcatecholamineCA(norepinephrineNEandepinephrineE)changetoreflectthestresschangeofendotrachealintubation.Methods：50patientswererandomlydividedintotwogroups,25patientsineachgroup.ThegroupIisesmololgroup,thegroupIIisthelidocainegrou

5、p.Twogroupsofpatientswereinjectedfentanyl2μg?kg-l,propofol2mg?kg-l,vecuronium0.1mg?kg-lbeforeintubation.ThepatientsingroupIwasinjectedEsmolol2mg?kg-l2minbeforeendotrachealintubation；ThepatientsingroupIIwasinjectedLidocainelmg?kg-l2minbeforeendotrachealintubationandIntherestoftheoperation,

6、twogroupsarethesame•ContinuedtorecordSBP,DBP,HRindexfromtheanesthesiainductiontolOminafterintubationandsuckthearterialbloodincorrespondingperiodtomonitortheconcentrationchangesofcatecholamines.Result：InadditiontoheartrateofthepatientsingroupIatlaryngoscopeexposureand3minaftertrachealintubati

7、onwassignificantlylowerthanthatgroupII(p<0.05)，andbloodpressure,heartrateandotherindicatorsduringintubationshowednosignificantchanges.butCatecholamineconcentrationsingroupIIatintubationand3minafterintubation(p<0.05)decreasedsignificantlycompa