醒脑静注射液对老年患者全静脉麻醉恢复期心率变异性的影响(1)

http://www.100md.com 2010年6月1日 舒爱华 方海滨 占乐云 王强 余艳丽 吕恩

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     【摘要】 目的 研究醒脑静注射液(XNJI)对老年患者全静脉麻醉恢复期心率变异性(HRV)的影响。方法 80例择期全静脉麻醉下行腹部手术的老年患者,随机分为XNJ组(X组)和对照组(C组),各40例。入恢复室后,X组患者在10 min内滴注催醒液100 ml(含XNJI0.5 ml/kg),C组患者则给与等量生理盐水。记录两组患者给药前(T0)、给药后不同时点的平均动脉压(MAP)和心率(HR),及动脉血肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(COR)浓度;并记录总频功率(TP)、低频功率(LF)、高频功率(HF)、低/高频功率比(LF/HF)。结果 MAP、HR两组均上升,C组苏醒时明显高于T0,且与X组比较有统计学意义(P<0.05);E、NE,X组在给药前后无明显变化,C组升高,且与X组比较有统计学意义(P<0.05);两组COR均升高,其中C组在围拔管期高于X组,差异有统计学意义(P<0.05);两组的HRV中TP、LF、HF在拔管前上升至最高并在拔管后回落,X组的LF/HF无明显变化,而C组LF/HF在围拔管期高于T0且高于X组,差异有统计学意义(P<0.05)。结论 醒脑静注射液用于老年患者全静脉麻醉恢复期,可明显抑制拔管期应激反应,促进HRV的恢复、改善心脏自主神经的均衡性。

    【关键词】醒脑静注射液;全静脉麻醉;老年;心率变异性

    Effects of Xingnaojing injection on heart rate variability in elderly patients recovering from total intravenous anesthesia

    SHU Ai-hua,FANG Hai-bin,ZHAN Le-yun,et al.Department of Anesthesiology,the First Hospital of Yichang city,Yichang 443000,China

    【Abstract】 Objective To investigate the effects of Xingnaojing injection(XNJI) on heart rate variability in elderly patients recovering from total intravenous anesthesia.Methods 80 elderly patients undergoing elective abdominal surgery under total intravenous anesthesia were randomly divided into two groups:the XNJI group(group X,n=40) and the control group(group C,n=40).All patients were rapidly at PACU,patients in group X were administrated XNJI(0.5 ml/kg) within 10 min,and the same dose of saline for patients in group C.The indexes of heart rate(HR),mean artery pressure(MAP),the concentrations of arterial blood epinephrine(E),norepinephrine(NE),and cortisol(COR),and total frequency power(TP),low frequency(LF),high-frequency power(HF),low/high frequency power ratio(LF/HF) were detected at a series of time points:before administration(T0),5 min(T1),15 min(T2),30 min(T3),45 min(T4),and 2 hours(T5) after administration.Results No statistical difference of MAP、HR and the concentrations of epinephrine(E),norepinephrine(NE)was found at the time points in group X ......

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