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不同剂量加巴喷丁对正常血压患者喉镜检查和气管插管血流动力学反应的影响比较。

A comparison of different doses of gabapentin to attenuate the haemodynamic response to laryngoscopy and tracheal intubation in normotensive patients.

作者信息

Bafna Usha, Goyal Vipin K, Garg Ashish

机构信息

Associate Professor, SMS Medical College & Hospital, Jaipur, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):43-6.

Abstract

BACKGROUND

Laryngoscopy and intubation evokes a transient but marked sympathetic response manifesting as increase in heart rate, blood pressure & arrhythmias. We conducted a study to compare the effect of different doses of gabapentin on hemodynamics associated with laryngoscopy and intubation. PATIENTS #ENTITYSTARTX00026;

METHODS

Ninety normotensive patients (ASA I and II) between 20-60 years undergoing elective surgery requiring intubation were randomly allocated into three groups of 30 patients each. Group I received oral placebo, Group II received 600 mg of gabapentin and Group III received1000 mg of gabapentin, with sip of water 1 h prior to surgery in the operation theatre. Patients were premedicated with Glycopyrrolate, midazolam and fentanyl and induction was done with thiopentone sodium and succinylcholine. Heart rate, systolic, diastolic and mean arterial pressure were recorded at baseline, 0, 1, 3, 5 and 10 min after intubation.

RESULTS

MAP and HR were significantly increased in patients receiving placebo and 600 mg gabapentin after laryngoscopy and intubation compared to baseline value and Group III. Significant decrease in MAP was seen just after intubation, 1, 3, 5 and 10 min after (P < 0.001, P < 0.001, P < 0.05, P < 0.05 and P < 0.05 respectively) in Group III compared to Groups I and II. HR was significantly decreased within 10 min of intubation (P<0.001)) in Group III compared to Groups I and II.

CONCLUSION

Gabapentin1000 mg given 1 h before operation significantly attenuated the haemodynamic response to laryngoscopy and intubation in normotensive patients.

摘要

背景

喉镜检查及气管插管会引发短暂但显著的交感神经反应,表现为心率加快、血压升高及心律失常。我们开展了一项研究,以比较不同剂量的加巴喷丁对喉镜检查及气管插管相关血流动力学的影响。患者

方法

90例年龄在20至60岁之间、接受择期插管手术的血压正常患者(ASA I级和II级)被随机分为三组,每组30例。第一组口服安慰剂,第二组服用600毫克加巴喷丁,第三组服用1000毫克加巴喷丁,均于手术前1小时在手术室用水送服。患者术前使用格隆溴铵、咪达唑仑和芬太尼进行预处理,诱导使用硫喷妥钠和琥珀酰胆碱。在插管前、插管后0、1、3、5和10分钟记录心率、收缩压、舒张压和平均动脉压。

结果

与基线值及第三组相比,接受安慰剂和600毫克加巴喷丁的患者在喉镜检查及气管插管后平均动脉压和心率显著升高。与第一组和第二组相比,第三组在插管后即刻、1、3、5和10分钟时平均动脉压显著降低(分别为P < 0.001、P < 0.001、P < 0.05、P < 0.05和P < 0.05)。与第一组和第二组相比,第三组在插管后10分钟内心率显著降低(P<0.001)。

结论

术前1小时给予1000毫克加巴喷丁可显著减轻血压正常患者对喉镜检查及气管插管的血流动力学反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5f0/3146157/4cbf9bdf0baa/JOACP-27-43-g003.jpg

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