Objective: To observe the efficacy of Nicardipine and Diltiazem in attenuation the cardiovascular responses to laryngoscopy and tracheal intubation (LTI). Methods: 60 patients of ASA I - II were assigned to one of the following 3 groups at random, normal saline (group C), 0.2 mg/kg Diltiazem (group D) or 15 μg/kg Nicardipine (group N). The medication for study was administered intravenously 2 minutes before the initiation of LTI. Blood pressure (BP), heart rate (HR), stroke volume index (SVI) and cardiac index (CI) were recorded at designed time points, before induction, immediate and after the bolus injection, immediate and 1, 2, 3 min after LTI. Rate-pressure product (RPP) were calculated. Results: After intubation, the peak MAP and HR values in group C increased by 21.7% and 31.1% over the baseline values (P<0.01); changes of MAP and HR after tracheal intubation in group D were less than those in group C (P<0.05); In group N, the increase in MAP provoked by LTI were less than group C and HR increased by 42.5% over the baseline; CI, SVI increased slightly after the bolus of Diltiazem and Nicardipine. Conclusion: Nicardipine is effective in attenuating pressure response to tracheal intubation but can not prevent tachycardia; Diltiazem produced greater attenuation on the circulatory responses to tracheal intubation.%目的:观察地尔硫卓、尼卡地平预防气管插管期心血管反应的疗效.方法:将60例ASAⅠ～Ⅱ级的成年患者随机分为生理盐水组(C组)、尼卡地平15 μg/kg组(N组)、地尔硫卓0.2 mg/kg组(D组).在气管插管前2 min静脉推注.记录诱导前、给药时、给药后、气管插管时及插管后1、2、3 min 的血压(BP)、心率(HR)、心搏指数(SVI),心指数(CI),计算心率收缩压乘积(RPP=心率×收缩压).结果:插管后C组平均动脉压(MAP)、HR的峰值较基础值上升21.7%、31.1%(P<0.01);D组插管后MAP、HR均无明显增高,变化小于C组(P<0.05);N组插管后MAP无显著变化,但HR的峰值较基础值升高42.5%.静注地尔硫卓、尼卡地平后CI、SVI较给药前增加.结论:尼卡地平可减轻气管插管的升压反应,但不能防止心动过速的发生;地尔硫卓可有效抑制气管插管时的心血管不良反应.
展开▼
