| 摘要: |
| ［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（VAC）的影响。方法 招募2023年5月至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）。记录两组麻醉诱导前（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（LVSV）、有效动脉弹性（Ea）、左心室收缩末期弹性（Ees）、Ea与Ees的比值（Ea/Ees），以及术后拔管时间、麻醉后恢复室（PACU）停留时间、不良反应发生情况、阿托品和去氧肾上腺素使用情况、Ea/Ees>1.0的人数占比。结果 与T0时比较，E组Ea/Ees在T1～T3时上升，MAP、HR、LVSV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、LVSV及Ees在T1～T4时下降，Ea在T1～T3时上升，在T4时下降，差异有统计学意义（P<0.05）。E组HR和LVSV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、阿托品和去氧肾上腺素使用情况以及Ea/Ees>1.0的人数占比比较差异无统计学意义（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具有较好的安全性，但依托咪酯能更好地维持VAC。 |
| 关键词: 心室-动脉耦合 有效动脉弹性 左心室收缩末期弹性 依托咪酯 环泊酚 |
| DOI：10.3969/j.issn.1674-3806.2024.04.16 |
| 分类号:R 614 |
| 基金项目:广州市科技计划项目（编号：202103000022，202201011728） |
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| Effects of etomidate and ciprofol on ventricular-arterial coupling in elderly hypertension patients during induction of general anesthesia |
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HUANG Jingxiang1, CAO Yang1,2, PENG Weilong2, LUO Jianhua2
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1.College of Anesthesiology, Guizhou Medical University, Guiyang 550004, China; 2.Department of Anesthesiology, Guangzhou Red Cross Hospital, Guangdong 510220, China
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| Abstract: |
| ［Abstract］ Objective To analyze the effects of etomidate and ciprofol on ventricular-arterial coupling(VAC) in elderly hypertension patients during induction of general anesthesia. Methods A total of 57 elderly hypertension patients who underwent surgical treatment under general anesthesia in Guangzhou Red Cross Hospital from May 2023 to November 2023 were recruited and divided into etomidate group(group E, 28 cases) and ciprofol group(group C, 29 cases) by random number table method. Mean arterial pressure(MAP), heart rate(HR), left ventricle stroke volume(LVSV), effective arterial elastance(Ea), left ventricle end-systolic elastance(Ees) and Ea to Ees ratio(Ea/Ees) were recorded in the two groups before anesthesia induction(T0), 1 minute after anesthesia induction(T1), 2 minutes after anesthesia induction(T2), before tracheal intubation(T3) and 1 minute after completion of tracheal intubation(T4). The postoperative extubation time, length of stay at post-anesthesia care unit(PACU), incidence of adverse reactions, use of atropine and phenylephrine and the number of patients with Ea/Ees>1.0 were recorded in the two groups. Results Compared with those at T0, Ea/Ees increased at T1-T3, and MAP, HR and LVSV decreased at T1-T3, and HR increased at T4, and Ea increased at T1 and T2, and Ees decreased at T2-T4 in the group E. Compared with those at T0, Ea/Ees increased at T1-T4, and MAP, HR, LVSV and Ees decreased at T1-T4, and Ea increased at T1-T3 and decreased at T4 in the group C, and the differences were statistically significant(P<0.05). Compared with the group C, the group E had high HR and LVSV at T1-T4, low Ea/Ees at T1-T4, high MAP at T3 and T4, high Ees at T1, T3 and T4, and low Ea at T2, and the differences were statistically significant(P<0.05). There were no statistically significant differences in the postoperative extubation time, length of stay at PACU, incidence of adverse reactions, use of atropine and phenylephrine and the proportion of patients with Ea/Ees>1.0 between the two groups(P>0.05). Conclusion Both etomidate and ciprofol have good safety in the induction of anesthesia in elderly patients with hypertension, but etomidate can better maintain the VAC. |
| Key words: Ventricular-arterial coupling Effective arterial elastance Left ventricle end-systolic elastance Etomidate Ciprofol |
