不同剂量阿尔芬坦尼尔对老年患者快速序列输管的心血管反应的影响:一项并行控制的随机试验
Xiaobo Chen1, Mei Han1, Aihua Shu1
1Department of Anaesthesiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Xiling District, No. 4, Hudi Street, Yichang, 443000, China.
BMC anesthesiology
|August 13, 2024
概括
对于接受快速序列输管 (RSI) 的老年患者,20μg/kg的阿尔芬坦尼尔与普罗波福和埃托米达剂量提供了稳定的血液动力学. 这一剂量有效地管理心血管反应,而不会引起显著的不良影响.
科学领域:
- 麻醉学 麻醉学
- 心血管生理学心血管生理学
- 老年医学 老年医学
背景情况:
- 快速序列输管 (RSI) 对于在全腹患者的麻醉诱导期间预防吸入至关重要.
- 缺少针对RSI的标准化方案和药物选择,特别是在老年患者 (65岁以上) 中.
- 在老年人中,RSI对心血管的影响需要进一步研究.
研究的目的:
- 在老年患者 (65-80岁) 中,研究不同剂量的阿尔芬坦尼尔 (10-25微克/千克) 与普罗波福和埃托米达结合在RSI期间对心血管的影响.
- 评估对血液动力学参数和压力标志物的影响,如北上腺素和皮质醇.
主要方法:
- 96名老年患者被随机分配到四组,接受不同的阿尔芬坦尼尔剂量.
- 血液动力学参数 (HR,MAP,CI,EF) 和血中诺阿比内和皮质醇度在三个时间点进行测量.
- 记录了高血压,低血压,胆心梗塞和心动减速的发生率.
主要成果:
- 较低的阿尔芬坦尼尔剂量 (10-15μg/kg) 增加了心率,平均动脉压和压力标志物,同时降低了心脏指数和喷射率.
- 20μg/kg的剂量 (C组) 显示出血液动力学和压力标志物的微小显著变化.
- 较高剂量 (25μg/kg) 导致输管后血压降低和心脏功能降低,降低血压和心脏紧张率增加.
结论:
- 在老年患者的RSI中,20μg/kg的阿尔夫坦尼尔有效地减轻了输管治疗的心血管反应.
- 这一剂量平衡了管理输管应激的有效性,对心血管系统的不良影响最小.
- 与较低或较高剂量相比,它在这个人群中提供了更稳定的血液动力学特征.
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