预注甲氧明注射液对全麻诱导期低血压的防治作用(1)
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【摘要】 目的 观察预注甲氧明注射液对全麻诱导期低血压的防治效果。方法 选择全麻气管插管择期手术病人40例，随机分为甲氧明(A)组(n=20)和对照(C)组(n=20)。所有病例采用咪达唑仑0.05mg/kg,丙泊酚 2mg/kg,维库溴铵0.12mg/kg,芬太尼3ug/kg,顺序静脉全麻诱导，于芬太尼用药后3min插管。A组于丙泊酚后静注甲氧明1.5mg；C组则静注同等剂量生理盐水，每例分别于诱导前，诱导后1、2、3分钟，插管后即刻，插管后1、2、3、4、5、10、15分钟测量SBP、DBP和HR。结果 两组年龄，体重，ASA分级无统计学差异；C组诱导期SBP、DBP较基础值显著降低(P<0.01)，而A组未有显著下降。结论 适时适量地应用甲氧明能有效的预防全麻诱导期的低血压反应。
【关键词】 甲氧明；诱导；低血压；血流动力学
The Preventive Effect of Methoxamine from the Hypotension during the Induction of general anesthesia period
huang hui
Department of Anesthesiology, Neijiang first people’s hospital, Neijiang, Sichuan,China 641000
【Abstract】 Objective To investigate whether Methoxamine can prevent the hypotension induced by induction. Methods 40 ASAⅠ-Ⅱ patients without cardiovascular disease, who would be subject to general anesthesia and tracheal intubation, were involved in this investigation. they were randomly divided into 2 groups: group Methoxamine(A)(n=20)and group control(C)(n=20). Each patients received midazolam 0.05mg/kg, propofol 2mg/kg, vecuronium 0.12mg/kg and fentanyl 3ug/kg sequential intravenous induction, and were intubated for 3 mins after administration of fentanyl. In group A, patients received Methoxamine 1.5mg after propofol., whereas in group C, patients received the same amount of physiological saline. Systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) were monitored and recorded before induction,1,2,3mins after induction, immediately after intubation and 1,2,3,4,5,10,15mins after intubation respectively. Results there were no significant differences between two groups regarding their ages、body weights and ASA classification. During the period of induction, the SBP and DBP of group C has significant decline compare to basic value (P<0.05), but group A doesn’t have significant decline . Conclusions Methoxamine, if utilized at proper time and amount, can prevent the hypotension during the induction of general anesthesia period
【Key words】 Methoxamine Induction Hypotension Hemodynamic
全麻诱导期各种药物对心血管均有一定抑制作用，加之患者病情和术前禁食禁饮等因素引起相对血容量不足，使得诱导期极易发生血压下降甚至低血压。临床主要依靠容量预充等预防或在出现低血压之后再处理。但各种方法效果均有一定的局限性。甲氧明是一种强力的α1受体兴奋剂，本实验采用预防性注射甲氧明的方法，观察其对诱导期低血压的防治效果，旨在为临床提供一个新的防治全麻诱导期低血压的方法。
1 资料与方法
1.1 一般资料：选择ASAⅠ-Ⅱ级、拟行全麻气管插管择期手术病人40例，排除高血压，心血管疾患以及心动过缓者。随机分成两组：甲氧明组(A组)20例，对照组(C组)20例。
1.2 麻醉方法：所有病例术前常规禁食水8小时，入手术室后监测血压、心电图、氧饱和度，静脉予以乳酸林格氏液10ml/kg ......
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