超短效选择性β1-肾上腺素受体拮抗剂艾司洛尔在耳鼻喉外科中的应用

Q4 Medicine Scripta Medica Pub Date : 2022-01-01 DOI:10.5937/scriptamed53-37135
D. Lončar-Stojiljković, Ž. Maksimović, M. Đurić
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引用次数: 0

摘要

背景/目的:为了保证心血管的稳定和麻醉后的快速恢复,设计了全身平衡麻醉的概念。本临床试验旨在研究选择性耳鼻喉手术患者的心血管功能参数和麻醉后的恢复情况。方法:择期行耳鼻喉科手术的ASA I、II级患者40例,男女均可,随机分为两组。两组均连续静脉输注5%葡萄糖溶液,艾司洛尔组也输注艾司洛尔。艾司洛尔输注速率前5min为0.3 mg/kg/min,后5min为0.1 mg/kg/min。在麻醉和手术的关键阶段(诱导、插管、首次切口、手术操作、伤口缝合、拔管),监测收缩压和舒张压。麻醉后的恢复情况根据命令睁眼次数、自发睁眼次数和恢复完全定向的次数进行评估。心血管参数增加基线值的20%或更多时,用静脉注射芬太尼或与氟哌啶醇联合治疗,必要时在吸入混合物中加入0.5%的异氟醚。记录了药物的消耗情况。结果:与对照组相比,艾司洛尔在麻醉和手术最关键阶段的心血管参数值较稳定。两组间麻醉持续时间无差异。在艾司洛尔组,芬太尼、氟哌啶和七氟醚的用量较低。艾司洛尔组麻醉恢复速度快于对照组。结论:连续静脉滴注艾司洛尔可提高心血管稳定性,减少镇痛药和麻醉药的使用,有利于择期耳鼻喉外科全麻恢复。
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Use of an ultrashort-acting selective β1-adrenergic receptor antagonist esmolol in ear, nose and throat surgery
Background / Aim: The concept of general balanced anaesthesia was devised in order to assure cardiovascular stability and fast post-anaesthesia recovery. This clinical trial was organised in order to investigate the parameters of cardiovascular function and emergence from anaesthesia in elective ear, nose and throat (ENT) surgery patients. Methods: A total of 40 ASA I and II patients of both sexes scheduled for elective ENT surgery were randomly divided into two equal groups. Both groups received a continuous IV infusion of glucose 5 % solution and in the esmolol group this infusion also contained esmolol. Esmolol infusion rate was 0.3 mg/kg/min during the first 5 min and thereafter 0.1 mg/kg/min. In critical phases of anaesthesia and operation (induction, intubation, first incision, surgical manipulations, wound suture, extubation), systolic and diastolic blood pressure were monitored. Recovery after anaesthesia was assessed based on times of eye opening on command, spontaneous eye opening and regaining of full orientation. Increases in cardiovascular parameters by 20 % of the baseline values or more were treated with IV boluses of fentanyl, alone or with droperidol and, if necessary, by adding isoflurane 0.5 % to the inhalational mixture. Consumption of drugs was recorded. Results: Esmolol assured stable values of cardiovascular parameters that were in most critical phases of anaesthesia and operation lower than in the control group. The duration of anaesthesia did not differ between the groups. In the esmolol group, lower consumption of fentanyl, droperidol and sevoflurane was registered. Patients in the esmolol group emerged from anaesthesia faster than patients in the control group. Conclusion: Continuous IV infusion of esmolol assures better cardiovascular stability, necessitates lower consumption of analgesics and anaesthetics and results in faster emergence from general anaesthesia in elective ENT surgery.
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CiteScore
0.60
自引率
0.00%
发文量
13
审稿时长
4 weeks
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