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丙泊酚、依托咪酯及依托咪酯-丙泊酚复合制剂用于麻醉诱导时气管插管的血流动力学反应

Haemodynamic Responses to Tracheal Intubation Using Propofol, Etomidate and Etomidate-Propofol Combination in Anaesthesia Induction.

作者信息

Yağan Özgür, Taş Nilay, Küçük Ahmet, Hancı Volkan, Yurtlu Bülent Serhan

机构信息

Ordu University, School of Medicine, Department of Anesthesiology, Ordu, Turkey.

Harran University, School of Medicine, Department of Anesthesiology, Sanlıurfa, Turkey.

出版信息

J Cardiovasc Thorac Res. 2015;7(4):134-40. doi: 10.15171/jcvtr.2015.30. Epub 2015 Nov 26.

Abstract

INTRODUCTION

The aim of this study was to measure the haemodynamic responses to a etomidate-propofol combination used for anaesthesia induction and to compare the haemodynamic responses with the separate use of each drug.

METHODS

The patients were randomly divided into three groups as group P (n = 30, propofol 2.5 mg kg(-1)), group E (n = 30, etomidate 0.3 mg kg(-1)) and group PE (n = 30, propofol 1.25 mg kg(-1) + etomidate 0.15 mg kg(-1)). For each patient, the times of measurement of the heart rate (HR) and mean arterial pressure values were defined as baseline, after the induction, before the intubation, immediately after the intubation and 1, 2, 3, 4, 5 and 10 minutes after the intubation.

RESULTS

In all 3 groups, a significant decrease in MAP values were seen at T2 and T3 compared to the baseline values, and this decrease was greater in group P compared to that in group E and PE (P < 0.001, P < 0.01). A significant increase was seen in all 3 groups in the mean arterial pressure (MAP) value at T4 after the intubation. When the groups were compared with each other, this increase was greater in group E than in the other two groups (with group P, P < 0.001; with group PE, P < 0.01).

CONCLUSION

Etomidate-propofol combination may be a valuable alternative when extremes of hypotensive and hypertensive responses due to propofol and etomidate are best to be avoided.

摘要

引言

本研究旨在测量依托咪酯 - 丙泊酚联合用于麻醉诱导时的血流动力学反应,并将其与单独使用每种药物时的血流动力学反应进行比较。

方法

患者被随机分为三组,即P组(n = 30,丙泊酚2.5 mg·kg⁻¹)、E组(n = 30,依托咪酯0.3 mg·kg⁻¹)和PE组(n = 30,丙泊酚1.25 mg·kg⁻¹ + 依托咪酯0.15 mg·kg⁻¹)。对于每位患者,心率(HR)和平均动脉压值的测量时间定义为基线、诱导后、插管前、插管后即刻以及插管后1、2、3、4、5和10分钟。

结果

在所有三组中,与基线值相比,T2和T3时MAP值显著降低,且P组的降低幅度大于E组和PE组(P < 0.001,P < 0.01)。插管后T4时,所有三组的平均动脉压(MAP)值均显著升高。当组间比较时,E组的升高幅度大于其他两组(与P组比较,P < 0.001;与PE组比较,P < 0.01)。

结论

当最好避免因丙泊酚和依托咪酯引起的极端低血压和高血压反应时,依托咪酯 - 丙泊酚联合用药可能是一种有价值的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b130/4685278/89a80bfc51ee/JCVTR-7-134-g001.jpg

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