【摘要】 目的比较依托咪酯与异丙酚用于老年患者全麻诱导期间的血液动力学变化。方法选择年龄在60~75岁、ASAⅠ~II级的择期行腹腔镜胆囊摘除手术的老年病人40例,随机分为E、P两组(各20例)。E组:麻醉诱导给予咪唑安定0.06 mg.kg-1、芬太尼4μg.kg-1、阿曲库铵0.6 mg.kg-1、依托咪酯0.3 mg.kg-1;P组麻醉诱导给予咪唑安定0.06 mg.kg-1、芬太尼4μg.kg-1、阿曲库铵0.6 mg.kg-1、异丙酚0.5 mg.kg-1。结果E组诱导后2 min血压及脉率与麻醉前比较无明显变化(P>0.05),P组诱导后2 min血压及脉率较麻醉前下降明显(P<0.05)。插管后2 min与诱导后2 min相比,二组SBP上升明显(P<0.01~0.05),E组DBP和HR明显上升(P<0.05)。结论依托咪酯有益于血液动力学的稳定,尤其利于老年患者,但在抑制气管插管所致的心血管反应方面明显弱于异丙酚。更多还原

【Abstract】 Aim To evaluate the cardiovasvular response during induction of general anesthesia in elderly patients with etomidate and propofol.Methods 40 ASA Ⅰ~Ⅱ elderly patients undergoing laparoscopic cholecystectomy were randomly divided into etomidate(E) group and propofol(P) group(20 cases each group).Anesthesia was induced with midazolam(0.06 mg·kg-1),fentanyl(4 μg·kg-1),atracurium(0.6 mg·kg-1) and etomidate(0.3 mg·kg-1) in group E,and midazolam(0.06 mg·kg-1),fentanyl(4 μg·kg-1),atracurium(0.6 mg·kg-1) and propofol(0.5 mg·kg-1) in group P before intubation.Results Little change of BP and HR at 2 minute after induction of group E was found compared with the baseline,the differece was not significant(P>0.05).BP and HR markedly reduced at 2 minute after induction in group P(P<0.05).Compared with that at 2 minute after induction,at 2 minute after tracheal intubation,SBP of group E was significantly increased(P<0.01),SBP of group P clearly increased also(P<0.05).DBP and HR of group E increased clearly(P<0.05),but that of group P had little change.Conclusion A firm hemodynamics benefits from etomidate,especially for geriatrics,but the efficacy of etomidate is less than that of propofol on controlling the cardiovasular reaction led to by tracheal intubation.更多还原