国际麻醉学与复苏杂志   2012, Issue (6): 0-0
    
不同剂量艾司洛尔对气管插管诱发QT间期延长的影响
张良清, 朱小兵, 刘志群, 石翊飒1()
1.广州中医药大学附属中山医院
The effect of different doses of esmolol on the QTc interval during induction of anaesthesia in patients
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摘要：

目的 评价不同剂量艾司洛尔对气管插管诱发QT间期延长的影响。 方法 择期拟行腹腔镜下胆囊切除术患者60例，ASA分级Ⅰ或Ⅱ级，年龄20岁~60岁，用随机数字表法分为3组(每组20例)：对照组(C组)、艾司洛尔1组(E1)、艾司洛尔2组(E2)。E1 组于麻醉诱导前5 min给予艾司洛尔0.3 mg/kg，后持续0.1 mg•kg-1•min-1输注；E2 组麻醉诱导前5 min给予艾司洛尔0.3 mg/kg，后持续0.25 mg•kg-1•min-1输注；C组给予同容量的生理盐水。分别于给予艾司洛尔前(T0)、给予艾司洛尔后(T1)、给予依托咪酯后1 min(T2)、气管插管即刻(T3)、气管插管后30 s(T4)、2 (T5)、4 min(T6)记录平均动脉压(MAP)、心率(HR)，并描记心电图(ECG)，比较3组患者的血压、HR、QT间期不同变化。 结果 E1组和E2组在T1、T2、T4QT间期分别为(382±11)、(380±6)、(406±13)；(379±13)、(370±11)、(400±7) ms。与C组比较，E1组和E2组在T1、T2、T4 QT间期显著缩短(P＜0.05)，E1组和E2组之间差异无统计学意义(P＞0.05)。结论 静脉诱导期间静脉注射0.3 mg/kg，后持续0.1 mg•kg-1•min-1输注艾司洛尔或者0.3 mg/kg 后持续0.25 mg•kg-1•min-1输注艾司洛尔均可有效抑制气管插管诱发QT间期延长，有效抑制气管插管诱发的交感神经反射，但是0.3 mg/kg后持续0.25 mg•kg-1•min-1输注艾司洛尔更易导致低血压和心动过缓的发生。
关键词： 艾司洛尔；气管插管；QT间期
Abstract:

Objective To investigate the effect of esmolol on QT interval during induction of anaesthesia,and the effect of different doses of esmolol on the QTc interval during induction of anaesthesia in patients undergoing laparoscopic cholecystectomy. Methods Sixty patients were pro-spectively randomised to three groups: Gontrol group(group C), the esmolol Ⅰ group(group E1), the esmolol Ⅱ group(group E2). Esmolol was administered as a bolus 0.3 mg/kg, followed by a continuous infusion at 0.1 mg•kg-1•min-1 in Group E1; Esmolol was administered as a bolus 0.3 mg/kg, followed by a continuous infusion at 0.25 mg•kg-1•min-1 in group E2; C group received the same volume of saline. The electrocardiogram was recorded prior to induction of anaesthesia (T0), 5 min following the start of drug infusions(T1), 1 min following etomidate(T2), 3 min following vecuonium(T3), 30 s(T4), 2 min(T5) and 4 min(T6) after intubation. Results QTc interval at T1, T2, T4 in group E1 were (382±11), (380±6), (406±1) ms, and in group E2 were (379±13), (370±11), (400±7) ms.In group E1 and group E2, QTc interval was significantly shorter at T1, T2 and T4 compared to the control group (P＜0.05). Conclusions QTc interval increased following tracheal intubation during induction of anaesthesia. Infusion of different doses of esmolol can attenuated the QTc interval prolongation associated with tracheal intubation,but In group E1, Hypotension and Low heart rate is more occurred compared to group E2.
Key words: Esmolo;Tracheal intubation ;QTc interval