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目的:探讨静脉注射地尔硫革(恬尔心)对高血压患者气管插管心血管反应的影响。方法:选择行全麻下手术的高血压病患者28例。术前所有患者血压控制在21.5～18.0/13.3～10.0 kPa,手术当天停用降压药物。28例患者随机分成两组,每组各14例,Ⅰ组注入生理盐水10 mL,Ⅱ组注入地尔硫(艹卓)0.2 mg·kg~(-1)。地尔硫(艹卓)用生理盐水稀释到10 mL,微泵匀速经另一静脉通路与麻醉诱导药同时注入,至插管前2 min注射完毕。观察诱导前、后、插管后0,1,2,3 min收缩压(SBP)、平均动脉压(MAP)和心率(HR)、心电图(EKG)变化,计算收缩压与心率的乘积(RPP)。结果:从RPP结果看,Ⅰ组在插管后即刻和插管后1～3 min内均较诱导前升高,有差异有极显著性(P<0.01),而Ⅱ组仅在插管后即刻和插管后1 min时较诱导前有升高,而且P<0.05,插管2 min后恢复至诱导前水平。在插管后即刻和插管后1～3 min内Ⅱ组均较Ⅰ组有明显降低,差异有极显著性(P<0.01)。结论:气管插管前2 min静注地尔硫(艹卓)0.2 mg·kg~(-1)对高血压病患者全麻气管插管导致的心血管反应有明显抑制作用。
Objective: To investigate the effect of intravenous diltiazem on the cardiovascular response to tracheal intubation in hypertensive patients. Methods: Twenty-eight patients with hypertension were selected under general anesthesia. All patients underwent preoperative blood pressure control in the 21.5 ~ 18.0 / 13.3 ~ 10.0 kPa, antihypertensive drugs disabled on the day of surgery. Twenty-eight patients were randomly divided into two groups (n = 14 each). Group I received normal saline (10 mL) and group II received diltiazem 0.2 mg kg (-1). Diltiazem (艹 Zhuo) diluted with saline to 10 mL, micro-pump through another intravenous access at the same time with the anesthetic drug injection, injection 2 min before intubation. The systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate (HR) and electrocardiogram (EKG) at 0, 1, 2 and 3 minutes after intubation were observed before and after induction. ). Results: According to the results of RPP, in group Ⅰ, there was a significant difference (P <0.01) between immediately before intubation and 1 ~ 3 min after intubation, Immediately and 1 min after intubation than before induction increased, and P <0.05, 2 min after intubation returned to pre-induction level. Immediately after intubation and intubation after 1 ~ 3 min in group Ⅱ were significantly lower than the group Ⅰ, the difference was significant (P <0.01). Conclusion: Intravenous diltiazem 0.2 mg · kg ~ (-1) intravenously 2 h before intubation significantly inhibited the cardiovascular response to general anesthesia with tracheal intubation in hypertensive patients.