腹腔镜可调节胃束带术治疗病态肥胖症的麻醉处理-中华医学会麻醉学.docVIP

艾司洛尔对依托咪酯诱导气管插管时脑氧供需平衡和能量代谢的影响 张兰芳 余剑波 曹新顺 王丽 （天津市南开医院麻醉科 天津 300100） 摘要 目的: 探讨艾司洛尔对依托咪酯诱导气管插管时脑氧供需平衡和能量代谢的影响。方法：将择期腹部手术患者24例，随机分为艾司洛尔组（A）和对照组（B），每组各12例。A组全麻诱导应用依托咪酯、咪唑安定、芬太尼和维库溴胺，并在插管前30s静注艾司洛尔1 mg/kg；B组除不用艾司洛尔外，其余与A组相同。两组分别于全麻诱导前、气管插管后即刻记录MAP、HR,并同步采集颈内静脉和桡动脉血，检测血糖、血乳酸水平及血气分析。根据Fick公式分别计算脑动、静脉血氧含量差（Da–jvO2））））））the effect of esmolol on cerebral oxygen metabolism and energy metabolism during tracheal intubation induced by etomitade ZHANG lan-fang,YU jian-bo,CAO xin-shun ,WANG li.Department of Anesthesia,Tianjin Nankai Hospital,Tianjin(300100) [Abstract] Objective To investigate the effect of esmolol on cerebral oxygen metabolism and energy metabolism during tracheal intubation induced by etomitade. Method Twenty-four ASA I一Ⅱ patients undergoing selective operation on abdominal regions were enrolled in the study． The patients were randomized into two groups with 12 cases each:esmolol group (A) and control group(B).Each group was administered with midazolam ,etomitade, fentanyl, vecuronium during the induction of general anaesthesia.Esmolol was only administered with 1mg/kg before anaesthesia in group A. Mean arterial pressure(MAP),heart rate(HR) were recorded ,and the blood samples were taken from radial artery and internal jugular vein for determination of blood gas analysis ,glucose and lactic acid levels before the induction and after tracheal intubation ．The cerebral arterio-venous differences in oxygen content [ D(a-j v)02]，cerebral oxygen extraction rate(CERO2), glucose extraction rate(GluER), the cerebral arterio—venous differences in lactic acid contend[D(a-jv)Lac] were calculated according to the Fick formula. Result：In group A, compared with the data before induction, MAP and HR have no significance(P0.05),but D(a-j v)02 and CERO2 obvious decreased,at the same time,SjvO2 raised after tracheal intubation(P0.05).In group B,the data after tracheal intubation concluded MAP,HR, SjvO2 raised,and D(a-j v)02 and CERO2 obvious decreased(P0.01). Group B co