Lindgren L, Yli-Hankala A, Randell T, Kirvelä M, Scheinin M, Neuvonen P J
Department of Anaesthesia, University Central Hospital, Helsinki, Finland.
Br J Anaesth. 1993 Mar;70(3):306-10. doi: 10.1093/bja/70.3.306.
We have studied the haemodynamic changes, QT intervals and catecholamine responses to induction of anaesthesia and tracheal intubation in 24 ASA I patients allocated randomly to receive either propofol 2.5 mg kg-1 or thiopentone 5 mg kg-1 over 60 s. After disappearance of the eyelash reflex, the lungs were ventilated with 100% oxygen for 3 min. The trachea was intubated after administration of vecuronium. With thiopentone, heart rate (HR) was greater than with propofol before intubation (P < 0.05). During induction, systolic (SAP) and diastolic arterial pressure (DAP) decreased more with propofol than with thiopentone. The QT interval was prolonged only during induction with thiopentone. In both groups, HR, SAP, DAP and the QT were increased in response to intubation (P < 0.001). The SAP and QT interval responses to intubation were significantly greater with thiopentone than with propofol (P < 0.05). One patient in the thiopentone group with a significantly prolonged QT interval had episodes of bigeminy and ventricular tachycardia. In both groups, concentrations of noradrenaline in mixed venous plasma increased after intubation (P < 0.001). Concentrations of adrenaline increased after intubation only in the thiopentone group (P < 0.001).
我们研究了24例随机分配接受在60秒内静脉注射异丙酚2.5mg/kg或硫喷妥钠5mg/kg的美国麻醉医师协会（ASA）I级患者，在麻醉诱导和气管插管过程中的血流动力学变化、QT间期及儿茶酚胺反应。睫毛反射消失后，用100%氧气进行3分钟的肺通气。注射维库溴铵后进行气管插管。使用硫喷妥钠时，插管前心率（HR）高于使用异丙酚时（P<0.05）。诱导期间，异丙酚组收缩压（SAP）和舒张压（DAP）的下降幅度大于硫喷妥钠组。仅在硫喷妥钠诱导期间QT间期延长。两组中，插管后HR、SAP、DAP和QT均升高（P<0.001）。硫喷妥钠组对插管的SAP和QT间期反应明显大于异丙酚组（P<0.05）。硫喷妥钠组有1例患者QT间期显著延长，出现了二联律和室性心动过速。两组中，插管后混合静脉血浆中去甲肾上腺素浓度升高（P<0.001）。仅硫喷妥钠组插管后肾上腺素浓度升高（P<0.001）。
