| 摘要: |
| 目的 分析依托咪酯与环泊酚在全麻诱导期对老年高血压患者心室-动脉耦合的影响。方法 招募2023年5月至2023年11月于广州市红十字会医院行全身麻醉手术治疗的57例老年高血压患者，采用随机数字表法将其分为依托咪酯组（E组，28例）和环泊酚组（C组，29例）。记录两组患者诱导前（T0），诱导1 min后（T1）、2 min后（T2），气管插管前（T3）和插管完成1 min后（T4）的平均动脉压（MAP）、心率（HR）、左心室每搏输出量（SV）、有效动脉弹性（Ea）、左心室收缩末期弹性（Ees）和Ea / Ees。记录两组患者术后拔管时间、麻醉恢复室（PACU）停留时间、不良反应发生情况、气管插管前阿托品和去甲肾上腺素使用情况以及Ea / Ees>1.0的人数。 结果 与T0时比较，E组Ea / Ees在T1～T3时上升，MAP、HR、SV在T1～T3时下降，HR在T4时上升，Ea在T1、T2时上升，Ees在T2～T4时下降；C组Ea / Ees在T1～T4时上升，MAP、HR、SV及Ees在T1～T4时下降，Ea在T1～T3时上升,在T4时下降，差异均有统计学意义（P <0.05）。与C组比较，E组HR和SV在T1～T4时高于C组，Ea / Ees在T1～T4时低于C组，MAP在T3、T4时高于C组，Ees在T1、T3、T4时高于C组，Ea在T2时低于C组，差异均有统计学意义（P <0.05）。两组术后拔管时间、PACU停留时间、不良反应发生率以及气管插管前阿托品使用情况比较差异无统计学意义（P >0.05）。C组气管插管前去氧肾上腺素使用人数和Ea / Ees>1.0的人数占比高于E组，差异有统计学意义（P <0.05）。结论 依托咪酯和环泊酚在老年高血压患者的麻醉诱导中均具有较好的安全性，但依托咪酯能更好地维持心室-动脉耦合和血流动力学稳定。 |
| 关键词: 心室动脉耦合 有效动脉弹性 左室收缩末期弹性 依托咪酯 环泊酚 |
| DOI： |
| 分类号: |
| 基金项目:广州市科技计划项目(编号:202103000022)；广州市科技计划项目（编号：202201011728） |
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| Effect of ventricular-arterial coupling of etomidate and ciprofol on induction of general anesthesia in elderly hypertensive patients. |
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黄静翔,luojianhua
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Guangzhou Red Cross Hospital
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| Abstract: |
| Objective analysis of the effects of etomidate and ciprofol on ventricular-arterial coupling during the induction of general anesthesia in elderly hypertensive patients. Methods Fifty-seven elderly hypertensive patients who underwent surgical treatment with general anesthesia at Guangzhou Red Cross Hospital from May 2023 to November 2023 were recruited and divided into the etomidate group (group E, 28 patients) and the ciprofol group (group C, 29 patients) using a randomized numerical table method.Record the average arterial pressure (MAP), heart rate (HR), left ventricle stroke volume (SV), effective arterial elastance (Ea), left ventricle end-systolic elastance (Ees), and Ea / Ees of two groups of patients before anesthesia induction (T0), 1 minute after anesthesia induction (T1), 2 minutes after anesthesia induction (T2), before tracheal intubation (T3), and 1 minute after tracheal intubation (T4).The postoperative extubation time, post-anesthesia care unit（PACU）recovery time, incidence of adverse events,use of atropine,phenylephrine and the number of patients with Ea / Ees>1.0 before tracheal intubation were recorded in both groups. Results Compared with T0, in group E,Ea / Ees increased at T1~T3, MAP, HR and SV decreased at T1~T3, HR increased at T4, Ea increased at T1 and T2, Ees decreased at T2~T4;in group C,Ea / Ees increased at T1~T4, MAP, HR, SV and Ees decreased at T1~T4, Ea increased at T1~T3 and decreased at T4,all differences were statistically significant(p<0.05).Compared with group C, groups E had higher HR and SV at T1-T4, lower Ea / Ees at T1-T4, higher MAP at T3 and T4, higher Ees at T1, T3, and T4, and lower Ea at T2,all differences were statistically significant(p<0.05).There were no statistically significant differences in postoperative extubation time, PACU recovery time, incidence of adverse events and use of atropine before tracheal intubation between the two groups（P >0.05）.Before tracheal intubation, the proportion of phenylephrine use and Ea / Ees > 1.0 in group C was significantly higher than that in group E, all differences were statistically significant(p<0.05). Conclusion Both etomidate and ciprofol have good safety profiles in elderly hypertensive patients during anesthesia induction,but etomidate can better maintain the ventricular-arterial coupling and hemodynamic stability. |
| Key words: Ventricular-arterial coupling Effective arterial elastance Left ventricle end-systolic elastance Etomidate Ciprofol |
