【摘要】 目的:探讨艾司洛尔在麻醉和复苏中的合理用量及临床效果。方法:选择2013年3月—2015年3月于收治92例行无痛胃肠镜检查患者作为研究对象,按随机数字表法分为A、B、C三组,其中A组患者30例给予艾司洛尔0.5 mg/kg,B组32例患者给予艾司洛尔1.0 mg/kg,C组30例患者给予0.9%氯化钠注射液,观察比较3组患者给药前(T0)、麻醉诱导后(T1)、胃镜过声门(T2)、胃镜至十二指肠(T3)时的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)变化、麻醉药物用量、留院观察及麻醉清醒的时间及不良反应发生情况。结果:C组患者T1、T2、T3时HR、MAP水平均显著高于A、B组,且A组患者各指标明显高于B组,差异均有统计学意义(P<0.05);C组患者的留院观察时间、麻醉清醒时间为(50.2±6.4)、(5.2±1.1)min,均明显高于A组的(30.3±6.2)、(2.5±1.1)min和B组的(30.3±6.0)、(2.4±1.2)min,差异均有统计学意义(P<0.05);C组患者丙泊酚、瑞芬太尼用量为(2.2±0.3)mg/kg、(0.36±0.05)μg/kg,明显多于A组的(2.0±0.2)mg/kg、(0.35±0.04)μg/kg和B组的(3.4±0.4)mg/kg、(0.42±0.08)μg/kg,差异均有统计学意义(P<0.05);3组患者均未见明显不良反应。结论:不同剂量艾司洛尔应用于无痛胃肠镜镇静麻醉与麻醉复苏时麻醉效果较好,且安全有效,值得临床推广。更多还原

【Abstract】 OBJECTIVE: To probe into the rational dosage and clinical effects of esmolol in anesthesia and resuscitation. METHODS: 92 cases receiving painless gastroscopy admitted into our hospital from Mar. 2013 to Mar.2015 were selected to be divided into group A,group B and group C via the random number table. 30 cases in group A were treated with 0. 5 mg / kg esmolol,32 cases in group B were given 1. 0 mg / kg esmolol,and another 30 cases in groupC received 0. 9% sodium chloride injection. The heart rate( HR),changes of mean arterial pressure( MAP),the consumption amount of narcotics,length of stay in hospital for observation,awake time of anesthesia and adverse reactions at before administration( T0),after anesthesia induction( T1),gastroscope over the glottis( T2) and gastroscope over the duodenum( T3) were observed in three groups. RESULTS: The levels of HR and MAP of group C at T1,T2,T3 were significantly higher than that of group A and group B,and group A were higher than group B,with statistically significant difference( P < 0. 05). The length of stay in hospital for observation and awake time of anesthesia in group C were significantly higher than that in group A and group B [( 50. 2 ± 6. 4) min VS( 30. 3 ± 6. 2) min VS( 30. 3 ± 6. 0)min,( 5. 2 ± 1. 1) min VS( 2. 5 ± 1. 1) min VS( 2. 4 ± 1. 2) min ],the difference was significant( P < 0. 05). The dosage of propofol and remifentanil in group C were also significantly higher than that in group A and group B[( 2. 2 ±0. 3) μg / kg VS( 2. 0 ± 0. 2) μg / kg VS( 3. 4 ± 0. 4) μg / kg,( 0. 36 ± 0. 05) mg / kg VS( 0. 35 ± 0. 04) mg / kg VS( 0. 42 ± 0. 08) mg /kg],with statistically significant difference( P < 0. 05). There were no obvious adverse reactions in three group of patients. CONCLUSIONS: Different doses of esmolol in painless gastroscopy sedation anesthesia and anesthesia resuscitation has a significant,safe and effective efficacy,which is worthy of clinical promotion.更多还原