期刊文献艾司洛尔对依托咪酯诱导气管插管时脑氧供需平衡和能量代谢的影响张兰芳余剑波曹新顺王丽（天津市南开医院麻醉科天津300100）摘要目的:探讨艾司洛尔对依托咪酯诱导气管插管时脑氧供需平衡和能量代谢的影响。方法：将择期腹部手术患者24例，随机分为艾司洛尔组（A）和对照组（B），每组各12例。A组全麻诱导应用依托咪酯、咪唑安定、芬太尼和维库溴胺，并在插管前30s静注艾司洛尔1mg/kg；B组除不用艾司洛尔外，其余与A组相同。两组分别于全麻诱导前、气管插管后即刻记录MAP、HR,并同步采集颈内静脉和桡动脉血，检测血糖、血乳酸水平及血气分析。根据Fick公式分别计算脑动、静脉血氧含量差（Da–jvO2），脑氧摄率（CERO2），葡萄糖摄取率（GluER），脑动、静脉血乳酸浓度差（Da–jvLac）。结果：插管后即刻与诱导前比较：A组MAP、HR无显著变化（P>0.05）,SjvO2增高，而Da–jvGlu和CERO2降低（P<0.05）；B组MAP、HR及SjvO2明显增高，Da–jvGlu和CERO2显著降低（P<0.01）。两组插管后即刻相比较：MAP、HR及SjvO2B水平B组明显高于A组，Da–jvGlu和CERO2水平B组明显低于A组，差异有统计学意义（P<0.05或P<0.01）。两组GluER、Da–jvLac无显著变化（P>0.05）。结论：麻醉诱导时给予艾司洛尔1mg.kg-1可减轻依托咪酯诱导气管插管对脑氧供需平衡的影响，但不影响脑的能量代谢。关键词：艾司洛尔；气管插管；脑／代谢；氧耗量theeffectofesmololoncerebraloxygenmetabolismandenergymetabolismduringtrachealintubationinducedbyetomitadeZHANGlan-fang,YUjian-bo,CAOxin-shun,WANGli.DepartmentofAnesthesia,TianjinNankaiHospital,Tianjin(300100)[Abstract]ObjectiveToinvestigatetheeffectofesmololoncerebraloxygenmetabolismandenergymetabolismduringtrachealintubationinducedbyetomitade.MethodTwenty-fourASAI一Ⅱpatients期刊文献undergoingselectiveoperationonabdominalregionswereenrolledinthestudy．Thepatientswererandomizedintotwogroupswith12caseseach:esmololgroup(A)andcontrolgroup(B).Eachgroupwasadministeredwithmidazolam,etomitade,fentanyl,vecuroniumduringtheinductionofgeneralanaesthesia.Esmololwasonlyadministeredwith1mg/kgbeforeanaesthesiaingroupA.Meanarterialpressure(MAP),heartrate(HR)wererecorded,andthebloodsamplesweretakenfromradialarteryandinternaljugularveinfordeterminationofbloodgasanalysis,glucoseandlacticacidlevelsbeforetheinductionandaftertrachealintubation．Thecerebralarterio-venousdifferencesinoxygencontent[D(a-jv)02]，cerebraloxygenextractionrate(CERO2),glucoseextractionrate(GluER),thecerebralarterio—venousdifferencesinlacticacidcontend[D(a-jv)Lac]werecalculatedaccordingtotheFickformula.Result：IngroupA,comparedwiththedatabeforeinduction,MAPandHRhavenosignificance(P>0.05),butD(a-jv)02andCERO2obviousdecreased,atthesametime,SjvO2raisedaftertrachealintubation(P<0.05).IngroupB,thedataaftertrachealintubationconcludedMAP,HR,SjvO2raised,andD(a-jv)02andCERO2obviousdecreased(P<0.01).GroupBcomparedwithgroupA,thedataaftertrachealintubationconcludedMAP,HRandSjvO2raised,D(a-jv)02,CERO2obviousdecreased(P<0.05orP<0.01),butGluERandD(a-jv)Lachavenosignificance(P>0.05).Concusion:esmololcanpartlydepressthecerebraloxygenmetabolismduringtrachealintubationinducedbyetomitade,butesmololhasnoeffectonenergymetabolism.[Keywords]esmolol；trachealintubation；cerebraloxygenmetabolism；energymetabolism全麻诱导气管插管可导致机体强烈的应激反应，对机体内环境造成一定影响［【1】。艾司洛尔是一种超短效选择性β1受体阻滞剂，由于能减轻气管插管引起的应激性心血管反应而广泛应用全麻诱导，但艾司期刊文献洛尔对全麻气管插管时脑氧与能量代谢的影响研究较少。本文通过观察全麻诱导前与气管插管后即刻血液动力学及SjvO2、Da–jvGlu、CERO2、GluER和Da...