Jee Daelim, Moon Hi-Lim
Department of Anesthesiology, Yeungnam University College of Medicine, Daegu, South Korea.
J Clin Anesth. 2004 Dec;16(8):563-7. doi: 10.1016/j.jclinane.2004.01.008.
To determine whether gender affects the hemodynamic response to anesthesia induction and intubation in young adults.
Randomized clinical trial.
University hospital.
83 healthy patients, aged 20 to 30 years, scheduled for orthopedic, plastic, and general surgery.
Patients were randomly allocated to one of three groups: Anesthesia was induced with fentanyl 1.5 microg/kg and thiopental 3 mg/kg in Group 1 (n = 28, men) and Group 2 (n = 28, women), or fentanyl 1.5 microg/kg and thiopental 2 mg/kg in Group 3 (n= 27, women) and maintained with enflurane 1% in N2O-O2 throughout the observational period. Three minutes after induction, direct laryngoscopy and intubation were performed.
Noninvasive systolic (SBP) and diastolic (DBP) blood pressures, and heart rate (HR) were recorded before induction (baseline), immediately before intubation, immediately after intubation, and then every 1 minute for 5 minutes after intubation.
SBP, DBP, and HR did not differ between men and women at baseline. However, SBP and DBP were lower in women than in men (p < 0.05) and immediately before intubation and at overall time points after intubation. There were no significant differences noted in SBP, DBP, and HR between Groups 2 and 3. When compared with baseline values, SBP and DBP were decreased in women, whereas only DBP was decreased in men immediately before intubation (p < 0.05). The increase in SBP was more prolonged in men after intubation.
Pressor response is different in women than men, suggesting the difference of the response might result from the gender differences.
确定性别是否影响年轻成年人麻醉诱导和插管时的血流动力学反应。
随机临床试验。
大学医院。
83名年龄在20至30岁之间、计划接受骨科、整形和普通外科手术的健康患者。
患者被随机分为三组之一:第1组(n = 28,男性)和第2组(n = 28,女性)用1.5微克/千克芬太尼和3毫克/千克硫喷妥钠诱导麻醉,第3组(n = 27,女性)用1.5微克/千克芬太尼和2毫克/千克硫喷妥钠诱导麻醉,并在整个观察期用1%恩氟烷维持于氧化亚氮 - 氧气中。诱导后3分钟,进行直接喉镜检查和插管。
在诱导前(基线)、插管前即刻、插管后即刻以及插管后5分钟内每1分钟记录无创收缩压(SBP)、舒张压(DBP)和心率(HR)。
基线时男性和女性的SBP、DBP和HR无差异。然而,女性的SBP和DBP在插管前即刻和插管后的所有时间点均低于男性(p < 0.05)。第2组和第3组之间的SBP、DBP和HR无显著差异。与基线值相比,女性的SBP和DBP降低,而男性仅在插管前即刻DBP降低(p < 0.05)。男性插管后SBP升高的持续时间更长。
女性的升压反应与男性不同,提示这种反应差异可能源于性别差异。