中国药物警戒 ›› 2017, Vol. 14 ›› Issue (5): 313-316.

• 安全性评价与合理用药 • 上一篇    下一篇

青少人群经不同剂量依托咪酯诱导麻醉时的血压、脉压、心率及不良反应的差异对比

王磊, 王春雪   

  1. 北京市丰台医院桥北部,北京 100071
  • 收稿日期:2017-07-12 修回日期:2017-07-12 出版日期:2017-05-20 发布日期:2017-07-12

Comparison of Blood Pressure, Pulse Pressure, Heart Rate and Adverse Reaction Between Different Dosage of Etomidate-induced Anesthesia in Adolescents

WANG Lei, Wang chun-xue   

  1. Qiaobei branch of Fengtai hospital in Beijing city, Beijing 100071, China
  • Received:2017-07-12 Revised:2017-07-12 Online:2017-05-20 Published:2017-07-12

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摘要： 目的 探讨青少人群经不同剂量依托咪酯诱导麻醉时的血压、脉压、心率及不良反应的差异对比。方法 选取于2013年2月至2016年4月期间,年龄在17~40岁之间,在我院行全麻手术的患者150例,按照剂量和诱导药物的不同,随机分为5组：E3（依托咪酯300μg·kg-1）、E4（依托咪酯400 μg·kg-1）、E5（依托咪酯500 μg·kg-1）、E6（依托咪酯600 μg·kg-1）、P（异丙酚2 mg·kg-1）。观察并记录5组患者在基础状态（T0）、气管插管前1 min（T1）、插管即刻（T2）、插管后1 min（T3）、插管后3 min（T4）、插管后5 min（T5）时各组的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）、脑电双频指数（BIS）的变化及不良反应。结果 与T0比较,五组诱导后,患者的BIS均降低（P<0.05）,E6组的SBP、DBP、MAP显著降低（P<0.05）,E3组插管后SBP、DBP、MAP显著上升,E4和E5组相对较平稳;与P组相比,E3组的BIS、SBP、DBP和MAP显著高于P组（P<0.05）,HR在T1时显著高于P组（P<0.05）;E6组的BIS、DBP和MAP显著低于P组（P<0.05）,SBP在T1时显著低于P组（P<0.05）,HR与P组无差异（P>0.05）;E4组的BIS、DBP和HR与P组差异较小（P>0.05）,SBP在T1、T3、T4、T5时显著高于P组（P<0.05）,MAP在T1、T4、T5时显著高于P组（P<0.05）;E5组各项指标与P组无差异（P>0.05）。结论 400 μg·kg-1~500 μg·kg-1浓度范围内的依托咪酯对青少人群的麻醉诱导效果较好,各项指标变化较平稳。

关键词: 青少人群, 不同剂量, 依托咪酯, 诱导麻醉, 血流动力学

Abstract: Objective To observe and compare the differences of blood pressure, pulse pressure, heart rate and adverse reactions at different doses of etomidate during anesthesia induction in adolescents. Methods 150 cases patients with general anesthesia in our hospital were collected from February 2013 to April 2016, the age of 17 to 40 years old, according to the different dose and induced drugs were randomly divided into 5 groups: E3 (etomidate 300 g·kg-1), E4 (etomidate 400 g·kg-1), E5 (etomidate 500 g·kg-1), E6 (etomidate 600 g·kg-1), P (propofol 2 mg·kg-1). The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), Brain electric dual frequency index (BIS) and adverse reactions at T0, T1, T2,T3, T4 and T5 timing were observed and recorded. Results Compared with T0, the patients of BIS were significantly decreased in the five groups after induction, (P<0.05), SBP, DBP, MAP of E6 group were significantly decreased (P<0.05), after intubation, the SBP, DBP, MAP of E3 group were significantly increased, E4 and E5 group were relatively stable. Compared with the P group, BIS, SBP, DBP and MAP in the E3 group were significantly higher than those in the P group (P <0.05), and HR was significantly higher than that of P group at T1 (P < 0.05).The BIS, DBP and MAP of E6 group were significantly lower than those of P group (P <0.05), SBP was significantly lower than that of P group at T1 (P <0.05), HR and P group were no difference (P> 0.05). The difference of BIS, DBP and HR between E4 group and P group was not significant (P> 0.05). SBP was significantly higher at T1, T3, T4 and T5 than that in group P (P <0.05), MAP at T1, T4 and T5 was significantly higher than that of P group (P <0.05). There was no significant difference between E5 group and P group (P> 0.05). Conclusion The concentration of etomidate within the scope of 400 μg·kg-1~500 μg·kg-1 has good effect in adolescents anesthesia induction, and the indicators change is relatively stable.

Key words: adolescents, different doses, etomidate, induced anesthesia, hemodynamics

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