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目的 :观察异丙酚麻醉诱导对血压、心率及内皮依赖性血管调节的影响。方法 :心肺功能正常的择期非心脏手术病人 18例 ,用异丙酚 2 0mg/kg、芬太尼 4μg/kg、潘库溴铵 0 0 8mg/kg和琥珀胆碱 1 5mg/kg麻醉诱导。记录诱导前、插管前和插管后 1、3和 5分钟时SBP、DBP、MAP和HR ,同时测定血浆内皮素 1、前列环素和血栓素A2 变化。结果 :插管前SBP、DBP和MAP均较诱导前明显降低 ,降幅分别为 30 0 %、2 1 5 %和 2 5 2 % ;插管后迅速升至诱导前水平。HR在各时期均无明显变化。插管前血栓素A2 降低 ,前列环素增加 ,T/K值降低 ,插管后逆转 ;内皮素 1无明显变化。结论 :异丙酚所致的血栓素A2 降低、前列环素增加和二者比例失调可能参与其低血压的发生
Objective: To observe the effects of propofol anesthesia on blood pressure, heart rate and endothelium-dependent vascular regulation. Methods: Eighteen patients with normal cardiopulmonary function under elective noncardiac surgery were induced by propofol 20 mg / kg, fentanyl 4 μg / kg, pancuronium 0.080 mg / kg and succinylcholine 15 mg / kg. The changes of plasma endothelin-1, prostacyclin and thromboxane A2 were recorded before induction, before intubation and at 1, 3 and 5 minutes after intubation, SBP, DBP, MAP and HR respectively. Results: Before intubation, SBP, DBP and MAP were significantly lower than those before induction, with a decrease of 30%, 25% and 25% respectively. After intubation, SBP, DBP and MAP rapidly increased to pre-induction level. HR in each period no significant change. Before intubation, thromboxane A2 decreased, prostacyclin increased, T / K decreased, reversed after intubation; endothelin 1 had no significant change. CONCLUSIONS: Propofol-induced reduction in thromboxane A2, increased prostacyclin, and an imbalance between the two may be involved in hypotension