艾司洛尔对老年冠心病患者气管插管QTc间期的影响

摘要

Objective To evaluate the effect of esmolol on the QTc interval during tracheal intubation after anesthesia induction in elderly patients with coronary artery disease. Methods Fifty patients aged 60-75y with ASA Ⅱ were randomly allocated either to esmolol (E) or to control (C)group. A bolus of 0. 3 mg/kg esmolol was administered to the group E and followed by a continuous infusion at a rate of 100 μg·kg-1 ·min-1; group C received same volume of saline. The changes in QTc, MAP and HR were recorded at following time points: prior to anesthesia induction (T0), 2 min after esmolol or saline injection (T1), 1 min following fentanyl and propofol delivery (T2), 3 min after vecuronium given (T3), 30 s (T4), 2 min (T5) and 4 min (T6) after intubation. Results QTc interval was enlarged significantly after intubation at T4, T5 and T6 than that of at T0 (P＜0.05), and this effect was far greater in the group C than the group E (P＜0. 01), and the number of patients with QTc intervals ＞ 440 ms were more in the control group than the esmolol one (P ＜ 0.05).Conclusion QTc interval enlarged following tracheal intubation during induction of anesthesia in elderly patients with coronary artery disease, but esmolol can attenuate such change in the QTc interval associated with tracheal intubation.%目的 评价艾司洛尔在麻醉诱导气管插管时对老年冠心病患者QTc间期的影响.方法 50例ASA Ⅱ级,年龄60～75岁择期全麻手术患者随机分为艾司洛尔组(E组)与对照组(C组).E组麻醉诱导前单次静脉缓慢注射艾司洛尔0.3 mg/kg后100 μg·kg-1·min-1持续输注至气管插管后4 mim;C组给予等容量生理盐水.记录给予艾司洛尔前(T0)、单次给予艾司洛尔或生理盐水后2 min(T1)、芬太尼与丙泊酚诱导后1 min(T2)、维库溴铵后3 min(插管前,T3)及插管后30 s(T4)、2 min(T5)与4 min(T6)QTc、MAP及HR变化.结果 T4～T6时QTc间期C组均长于T0时(P＜0.05),且C组明显长于E组(P＜0.01),其中QTc＞440 ms者C组显著多于E组(P＜0.05).结论 麻醉诱导气管插管期间老年冠心病患者QTc间期延长,而艾司洛尔可缩短与气管插管有关的QTc间期延长.