Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
Korean J Anesthesiol. 2012 Mar;62(3):245-50. doi: 10.4097/kjae.2012.62.3.245. Epub 2012 Mar 21.
Inspired concentrations of desflurane ≥ 1 minimum alveolar anesthetic concentration (MAC) have been related to sympathetic stimulation such as hypertension and tachycardia. The current study examined whether labetalol, an α(1) and β-adrenergic antagonist would blunt these hemodynamic responses.
Fifty-four ASA physical status I patients, aged 20-60 years, were enrolled in this study. The patients were randomly divided into 2 groups. The breathing circuit was primed with an end-tidal desflurane concentration of 1.2 MAC in 6 L/min O(2). Normal saline 5 ml or labetalol 0.3 mg/kg was injected into groups S and L respectively. After 5 minutes, anesthesia was induced with intravenous etomidate 0.2 mg/kg and vecuronium 0.1 mg/kg. Each patient inhaled desflurane through a tight fitting facemask. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and end-tidal concentration of desflurane (et-des) were measured at 5 minutes after saline or labetalol injection (baseline) and every 1 minute for 5 minutes after desflurane inhalation and for 2 minutes after intubation.
In the saline injection group (group S), desflurane inhalation increased heart rate and blood pressure, while labetalol 0.3 mg/kg attenuated the heart rate and blood pressure increase in group L. After tracheal intubation, heart rate and blood pressure were significantly lower in group L than in group S.
These results demonstrate that administration of intravenous labetalol is effective in attenuating tracheal intubation and desflurane-induced hemodynamic responses.
受 inspirations 浓度的地氟醚≥1 最低肺泡有效浓度（MAC）与交感神经刺激有关，如高血压和心动过速。本研究旨在探讨是否 labetalol（一种 α（1）和β-肾上腺素能拮抗剂）能减轻这些血流动力学反应。
54 名 ASA 身体状况 I 级患者，年龄 20-60 岁，纳入本研究。患者随机分为 2 组。呼吸回路以 6 L/min O(2)中的 1.2 MAC 地氟醚预充。分别向 S 组和 L 组注射生理盐水 5ml 或 labetalol 0.3mg/kg。5 分钟后，静脉注射依托咪酯 0.2mg/kg 和维库溴铵 0.1mg/kg 诱导麻醉。每位患者通过密闭面罩吸入地氟醚。心率（HR）、收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和呼气末地氟醚浓度（et-des）于生理盐水或 labetalol 注射后 5 分钟（基线）以及吸入地氟醚后每 1 分钟测量一次，持续 5 分钟，气管插管后再测量 2 分钟。
在生理盐水注射组（S 组）中，吸入地氟醚后心率和血压升高，而 labetalol 0.3mg/kg 可减轻 L 组的心率和血压升高。气管插管后，L 组的心率和血压明显低于 S 组。
这些结果表明，静脉注射 labetalol 可有效减轻气管插管和地氟醚引起的血流动力学反应。
