Cheng Ming-hua, Yao Yong-ming
Department of Anesthesiology, First Affiliated Hospital of Medical College, Shantou University, Shantou 515041, Guangdong, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2003 Jul;15(7):435-7.
To compare effects of esmolol and fentanyl on the hemodynamic and catecholamine response to tracheal intubation in hypertensive patients.
Sixty hypertensive patients were randomly allocated into one of four groups: the patients received 0.9% saline in group A, 2 mg/kg esmolol in group B, 2 microg/kg fentanyl in group C and 2 mg/kg esmolol combined with 2 microg/kg fentanyl in group D before intubation. Tracheal intubation was performed with 0.1 mg/kg midazolam, 0.6 mg/kg atracurium and 2 mg/kg propofol. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), heart rate (HR), rate-pressure product (RPP), plasma noradrenaline (NA) and adrenaline (A) concentrations were measured before and after intubation.
SAP, DAP, HR, RPP, NA and A levels in group A at 1 and 3 minutes after intubation were significantly higher than the baseline values (all P<0.01). NA levels in group B and SAP in group C increased significantly after intubation (both P<0.05). The hemodynamics and catecholamine in group D after intubation were not significantly different from the baselines (all P>0.05).
2 mg/kg esmolol or 2 microg/kg fentanyl can partly reduce hemodynamic response to intubation and 2 mg/kg esmolol combined with 2 microg/kg fentanyl can completely attenuate the hemodynamic and catecholamine response in hypertensive patients.
比较艾司洛尔和芬太尼对高血压患者气管插管时血流动力学及儿茶酚胺反应的影响。
60例高血压患者随机分为四组：A组患者插管前输注0.9%生理盐水；B组患者插管前输注2mg/kg艾司洛尔；C组患者插管前输注2μg/kg芬太尼；D组患者插管前输注2mg/kg艾司洛尔联合2μg/kg芬太尼。采用0.1mg/kg咪达唑仑、0.6mg/kg阿曲库铵和2mg/kg丙泊酚进行气管插管。于插管前后测量收缩压（SAP）、舒张压（DAP）、心率（HR）、率压积（RPP）、血浆去甲肾上腺素（NA）和肾上腺素（A）浓度。
A组插管后1分钟和3分钟时的SAP、DAP、HR、RPP、NA和A水平均显著高于基线值（均P<0.01）。B组NA水平和C组SAP在插管后显著升高（均P<0.05）。D组插管后的血流动力学和儿茶酚胺水平与基线值相比无显著差异（均P>0.05）。
2mg/kg艾司洛尔或2μg/kg芬太尼可部分减轻插管时的血流动力学反应，2mg/kg艾司洛尔联合2μg/kg芬太尼可完全减弱高血压患者插管时的血流动力学及儿茶酚胺反应。
