摘要
Abstract
AIM To evaluate the efficacy and safety of using esmolol, uradil and diltiazem to inhibit cardiovascular stress response during pneumoperitoneum in patients undergoing laparoscopic cholecystectomy. METHODS A total of 120 ASA I or II grades patients underwent laparoscopic cholecystectomy under total intravenous anesthesia. After anesthesia induction and tracheal intubation, the patients were randomly divided into 4 groups (30 patients for each group), control group received equal volume of saline, esmolol group received intravenous injection of 0.5 mg·kg-1 esmolol followed by continous pump infusion of esmolol at 0.05 mg· kg-1· min-1, uradil group received intravenous injection of 0.5 mg·kg-1 uradil and diltiazem group received intravenous injection of 0.25 mg·kg-1 diltiazem. Mean artery pressure (MAP), heart rate (HR) and the rate pressure product (RPP) were recorded before anesthesia induction(To), before pneumoperitoneum(T1), 1 min(T2), 5 min(T3) and 15 min(T4) after pneumoperitoneum and 5 min after deflation(T5) . Total requirement of propofol during pneumoperitoneum, the time from end of anesthesia to tracheal extubation and adverse drug reactions were compared in 4 groups. RESULTS MAP, HR and RPP significantly increased during pneumoperitoneum (T2 - T4) and recovered to base level after pneumoperitoneum (T5) in control group, and maintained steady from T2 to T5 in esmolol group. Although MAP, HR and RPP significantly increased during pneumoperitoneum in uradil and diltiazem groups, the increase amplitude and duration were much less than those in control group. Compared with control group, propofol requirement during pneumoperitoneum significantly reduced in esmolol, uradil and diltiazem groups, and the propofol requirement in esmolol group was less than that in uradil and diltiazem groups (P < 0.05). The time from end of anesthesia to tracheal extubation was significant shorter in 3 experiment groups than that in control group ( P < 0.05). CONCLUSION Esmolol, uradil and diltiazem can effectively inhibit cardiovascular stress response and reduce propofol requirement during penumoperitoneum in patients undergoing laparoscopic cholecystectomy.关键词
腹腔镜/气腹/丙泊酚/艾司洛尔/乌拉地尔/地尔硫(卓)Key words
laparoscope/ pneumoperitoneum/ propofol/ esmolol/ uradil/ diltiazem
