比较研究可乐定与艾司洛尔在腹腔镜胆囊切除术中的血流动力学反应

比较研究可乐定与艾司洛尔在腹腔镜胆囊切除术中的血流动力学反应
Comparative study of clonidine versus esmolol on hemodynamic responses during laparoscopic cholecystectomy

Abstract
摘要
Background
背景
Laparoscopic surgical procedures have various benefits to the patient in terms of decreased tissue damage, early ambulation, decreased hospital stay and reduced analgesic needs. Pneumoperitoneum with carbon dioxide (CO2) leads to stimulation of the sympathetic nervous system which can be a risk factor in patients with cardiovascular diseases. Moreover, reverse Trendelenburg position affects homeostasis in laparoscopic surgeries. In this study, we compared the efficacy of clonidine (which is α2 adrenergic agonist) versus esmolol (which is ultra short acting cardio-selective β1-receptor antagonist) on the hemodynamic response during laparoscopic cholecystectomy.
腹腔镜手术对病人组织损伤的减少有不同的好处，早期下床活动，减少住院时间和减少镇痛药的需求。二氧化碳（CO2）气腹导致交感神经系统的刺激，这可能是心血管疾病的危险因素。此外，头高位影响腹腔镜手术的平衡。在这项研究中，我们比较了可乐定的效果（这是α2肾上腺素受体激动剂）和艾司洛尔（它是超短效有氧选择性β1受体拮抗剂）在腹腔镜胆囊切除术中的血流动力学反应

Materials and methods
材料与方法
A total of 60 patients scheduled to undergo laparoscopic cholecystectomy were randomly assigned into two groups: Group C: received 2 μg/kg of clonidine diluted in 20 ml normal saline, given with slow intravenous infusion over 10 min just before induction of GA and Group E: received 1.5 mg/kg of esmolol as a loading dose over a period of 5 min just before induction of GA followed by 10 μg/kg/min as a maintenance dose throughout the procedure. No hypnotic medication was given on the evening before surgery. Systolic, diastolic, mean arterial blood pressures and heart rate were recorded at (1) baseline, (2) three minutes after endotracheal intubation, (3) before pneumoperitoneum, (4) fifteen minutes after pneumoperitoneum, (5) thirty minutes after pneumoperitoneum, (6) five minutes after release of CO2 and (7) five minutes after extubation. Degree of sedation according to Ramsay sedation score was assessed 15 min after reaching PACU.
共60例择期行腹腔镜胆囊切除术患者随机分为两组：C组：接受2μg/kg可乐定稀释于20毫升的生理盐水，在诱导前10分钟内缓慢静脉滴注和E组：接受1.5 mg/kg艾司洛尔作为负荷剂量，超过5分钟就在诱导GA，跟着10微克/公斤/分钟整个过程维持剂量。术前一天晚上不服用安眠药。收缩压、舒张压、平均动脉压和心率记录（1）基线，（2）气管插管后三分钟，（3）气腹前、气腹后十五分钟（4）、（5）气腹后三十分钟、（6）释放二氧化碳五分钟后和（7）拔管后五分钟。根据拉姆齐镇静评分的镇静程度进行了评估，15分钟后到达PACU

Results
结果
Both groups were similar with respect to demographic data. Clonidine group showed more stability in hemodynamic responses than esmolol group in all hemodynamic variables but with more postoperative sedation.
这两个群体的人口数据是相似的。在所有的血流动力学变量可乐定组的血流动力学反应比艾司洛尔组更稳定,但具有更多的术后镇静。

Conclusion
结论
This study concluded that clonidine and esmolol provide hemodynamic stability in laparoscopic cholecystectomy but clonidine provides more stability with postoperative sedation.
本文的研究结论表明，可乐定和艾司洛尔为腹腔镜胆囊切除术中提供血流动力学的稳定，但可乐定提供了更多的稳定性与术后镇静。

Keywords
关键词
Clondine; Esmolol; Laparoscopic cholecystectomy
可乐定；艾司洛尔；腹腔镜胆囊切除术

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腹腔镜胆囊切除术中的血流动力学反应可乐定与艾司洛尔的比较研究