摘要
Abstract
Objective To explore the effects of etomidate on hemodynamics and stress response in elderly hypertensive patients during general anesthesia induction with ProSeal laryngeal mask airway( PLMA). Methods From November 2010 to December 2011, sixty hypertension ASA II - III patients aged 65 -78 years scheduled for abdominal surgery were randomly divided into two groups. The patients were infused with etomidate during induction in E group(n =30) and propofol in P group(n =30). The patients were fast-induced and intubated with PLMA in two groups, and intravenous inhalation was used for maintenance. The systolic blood pressure (SBP) .diasLolic blood pressure ( DBP), heart rate ( HR), pulse oxygen saturation ( SpO2), blood glucose and plasma cortisol were recorded before induction of anesthesia (TO) .instant after induction (Tl) ,1 min after the intubation (T2) ,3 min after the intubation (T3), 5 min after die intubation(T4), 10 min after the intubation( T5) in two groups. Results Compared with TO, SBP, DBP at Tl, T3.T4.T5 and HR at Tl were significantly reduced in E group(P<0.05). SBP,DBP at Tl ,T4,T5 and HR at Tl were decreased in P group(P<0.05) .but SBP,DBP and HR were elevated at T2. SBP,DBP at T2,T3 and HR at T2 were significantly higher in P group than in E group (P < 0. 05). SpO2 and levels of blood glucose at each time point were not different from that at TO( P > 0. 05). Compared with TO, plasma cortisol levels gradually reduced at T3 , T4 and T5 in two groups, and the difference was significant in E group ( P < 0.05) but not in P group (P > 0.05). Plasma cortisol concentrations in E group were significantly lower than in P group at T3, T4, T5(P<0.05). Conclusion Intravenous administration of etomidate can attenuate the hemodynamic changes and inhibit the stress response during the ProSeal laryngeal mask airway (PLMA) intubation,and is more suitable for the induction of anesthesia in elderly patients with hypertension.关键词
依托咪酯/PLMA喉罩/高血压/应激反应/老年人Key words
etomidate/ ProSeal laryngeal mask airway/ hypertension/ stress response/ aged分类
医药卫生
