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目的 :比较常用静脉麻醉药对血流动力学的影响。方法 :80例拟行全麻患者随机分成八组 ,分别给予生理盐水 10ml、硫喷妥钠 6mg/kg、异丙酚 2 5mg/kg、咪唑安定 0 3mg/kg、依托咪酯丙二醇制剂 0 3mg/kg、依托咪酯乳剂0 3mg/kg、氯胺酮 2mg/kg和芬太尼 5 μg/kg。用Ultima监测仪和阻抗法记录并计算血液动力学有关参数。结果 :就BP而言 ,其降幅排序为异丙酚 >咪唑安定 >硫喷妥钠 >依托咪酯 ,芬太尼组无明显变化 ,氯胺酮组明显升高。对SI和CI的抑制 ,咪唑安定 >硫喷妥钠 >异丙酚 >依托咪酯 >芬太尼 >氯胺酮。左室作功除氯胺酮组明显增加外 ,其他组均降低 ,其排序为咪唑安定 >硫喷妥钠 >异丙酚 >依托咪酯 >芬太尼。结论 :芬太尼、依托咪酯对血液动力学影响较小 ,硫喷妥钠、异丙酚、咪唑安定影响较大 ,氯胺酮可有不同程度的心血管刺激作用。
Objective: To compare the hemodynamic effects of commonly used intravenous anesthetics. Methods: Eighty patients undergoing general anesthesia were randomly divided into eight groups, and were given normal saline 10ml, thiopental 6mg / kg, propofol 25mg / kg, midazolam 0 3mg / kg, etomidate propylene glycol preparation 0 3mg / kg, etomidate emulsion 0 3 mg / kg, ketamine 2 mg / kg and fentanyl 5 μg / kg. The Ultima monitor and impedance method were used to record and calculate hemodynamic parameters. Results: In terms of BP, the descending order was propofol> midazolam> thiopental sodium> etomidate, fentanyl group had no significant change, ketamine group was significantly higher. Inhibition of SI and CI Midazolam> thiopental> propofol> etomidate> fentanyl> ketamine. Left ventricular function in addition to ketamine group was significantly increased, the other groups were reduced, the order of midazolam> thiopental sodium> propofol> etomidate> fentanyl. CONCLUSION: Fentanyl and etomidate have little effect on hemodynamics. Thiopental, propofol and midazolam are more influential, and ketamine may have different degree of cardiovascular stimuli.