Gombotz H, Metzler H, Winkler G, Rehak P
Department of Anesthesiology, University of Graz, Austria.
Acta Anaesthesiol Scand. 1988 Nov;32(8):686-90. doi: 10.1111/j.1399-6576.1988.tb02809.x.
In a double-blind randomized protocol the effectiveness of the specific bradycardic agent alinidine (0.6 mg.kg-1 i.v.) was compared to that of the betablocker metoprolol (0.035 mg.kg-1 i.v.). Twenty-four coronary artery disease patients undergoing a bypass procedure with an intraoperative heart rate increase of more than 20% were included. Patients with a concomitant intraoperative mean arterial pressure increase of more than 30% or with an intraoperative wedge pressure higher than 15 mmHg (2.0 kPa) were excluded. After application of alinidine and metoprolol, heart rate decreased significantly (P less than 0.01) in the alinidine group from 88 +/- 19 beats per min to 72 +/- 13 and in the metoprolol group from 82 +/- 16 to 72 +/- 12. Baseline values were not obtained. Compared to the hemodynamic changes in the metoprolol group, the alterations of pulmonary capillary wedge pressure (PCWP) (P less than 0.05), stroke volume index (SVI) (P less than 0.05), left ventricular stroke work index (LVSWI) (P less than 0.01) and right ventricular stroke work index (RVSWI) (P less than 0.05) in the alinidine group were statistically significantly different. PCWP remained unchanged after alinidine and increased in the metoprolol group (1.4 +/- 0.4 to 1.6 +/- 0.4 kPa). In the alinidine group LVSWI (43.1 +/- 15 to 49.2 +/- 18 g-m.m-2), RVSWI (5.1 +/- 4 to 6.6 +/- 3 g-m.m-2) and SVI (37.2 +/- 12.2 to 42.5 +/- 12.8 ml.m-2) increased.(ABSTRACT TRUNCATED AT 250 WORDS)
在一项双盲随机试验方案中，将特异性心动过缓药物阿利尼定（静脉注射0.6毫克/千克）的有效性与β受体阻滞剂美托洛尔（静脉注射0.035毫克/千克）进行了比较。纳入了24例接受搭桥手术且术中心率增加超过20%的冠状动脉疾病患者。排除术中平均动脉压增加超过30%或术中楔压高于15毫米汞柱（2.0千帕）的患者。应用阿利尼定和美托洛尔后，阿利尼定组心率从每分钟88±19次显著下降（P<0.01）至72±13次，美托洛尔组从82±16次降至72±12次。未获取基线值。与美托洛尔组的血流动力学变化相比，阿利尼定组的肺毛细血管楔压（PCWP）（P<0.05）、每搏量指数（SVI）（P<0.05）、左心室每搏功指数（LVSWI）（P<0.01）和右心室每搏功指数（RVSWI）（P<0.05）的改变在统计学上有显著差异。阿利尼定应用后PCWP保持不变，美托洛尔组则升高（从1.4±0.4千帕升至1.6±0.4千帕）。在阿利尼定组，LVSWI（从43.1±15克-米/平方米升至49.2±18克-米/平方米）、RVSWI（从5.1±4克-米/平方米升至6.6±3克-米/平方米）和SVI（从37.2±12.2毫升/平方米升至42.5±12.8毫升/平方米）升高。（摘要截短于250字）
