Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan.
J Anesth. 2010 Oct;24(5):786-8. doi: 10.1007/s00540-010-0975-5. Epub 2010 Jul 21.
The objective of this study was to examine the effects of low-dose infusion of landiolol on hemodynamics during tracheal intubation in elderly patients with cardiovascular disease. The study population consisted of 30 patients with American Society of Anesthesiologists physical status II and III, aged 65-77 years, who were scheduled to undergo elective surgery under general anesthesia. Patients were randomly divided into two groups (n = 15 each): a control group, receiving normal saline, and a landiolol group, receiving landiolol at 30 μg/kg/min. After oxygenation, 1 μg/kg of fentanyl was injected intravenously, followed by continuous infusion of normal saline or landiolol for 5 min. General anesthesia was induced and maintained with target-controlled infusion of propofol at a blood concentration of 4 μg/ml and tracheal intubation was performed 3 min after vecuronium injection. Heart rate, blood pressure, and bispectral index were measured before and after tracheal intubation. Results showed that low-dose continuous infusion of landiolol is an effective and relatively safe method of preventing an intubation-induced adrenergic response in elderly patients with cardiovascular disease.
本研究旨在探讨小剂量静脉输注拉地洛尔对伴有心血管疾病的老年患者气管插管期间血流动力学的影响。研究对象为 30 例美国麻醉医师协会(ASA)身体状况 II 级和 III 级、年龄 65-77 岁、拟在全身麻醉下择期行手术的患者。患者随机分为两组(每组 15 例):对照组给予生理盐水,拉地洛尔组给予 30μg/kg/min 的拉地洛尔。氧合后静脉注射 1μg/kg 芬太尼,然后连续输注生理盐水或拉地洛尔 5min。采用丙泊酚靶控输注,血药浓度为 4μg/ml 诱导并维持全身麻醉,维库溴铵注射后 3min 行气管插管。在气管插管前后测量心率、血压和脑电双频指数。结果表明,小剂量持续输注拉地洛尔是预防伴有心血管疾病的老年患者气管插管引起的儿茶酚胺反应的一种有效且相对安全的方法。