依托咪酯和咪达唑仑在冠脉搭桥手术麻醉诱导期对脑电双频指数及血流动力学的影响临床医学.doc

依托咪酯和咪达唑仑在冠脉搭桥手术麻醉诱导期对脑电双频指数及血流动力学的影响临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：依托咪酯和咪达唑仑在冠脉搭桥手术麻醉诱导期对脑电双频指数及血流动力学的影响临床医学 1 1 资料与方法 2 2 结 果 3 3 讨 论 4 文2：依托咪酯联合丙泊酚对卵巢癌患者全麻诱导期血流动力学的影响 5 1 资料与方法 6 2 结果 7 3 讨论 7 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 10 正文 依托咪酯和咪达唑仑在冠脉搭桥手术麻醉诱导期对脑电双频指数及血流动力学的影响临床医学 文1：依托咪酯和咪达唑仑在冠脉搭桥手术麻醉诱导期对脑电双频指数及血流动力学的影响临床医学 Abstract: OBJECTIVE To compare the effect of etomidate and midazolam on hemodynamics and bispectral index（BIS） in cononary artery bypass grafting （CABG） patients during general anesthesia induction. METHODS Forty-six patients undergoing CABG surgery were randomized into two groups. Patients in groupⅠwere induced with etomidate ( mg/kg), patients in group Ⅱ were induced with midazolam ( mg/kg). Patients in both groups were injectived with lidocaine (1 mg/kg)、sulfentanyl(1 μg/kg) and vecuronium( mg/kg) before the intubation. The hemodynamics and BIS were recorded. RESULTS HB,SBP,MBP and BIS in both groups decreased significantly after the induction（P）. One minutes after induction，BIS decreased significantly in group Ⅱ than that in groupⅠ（P）.Three minutes after induction HR，SBP and MBP increased significantly in group Ⅱ than that in groupⅠ（P）. Five minutes after induction HR decreased significantly in group Ⅱ than that in groupⅠ（P）. CONCLUSION Etomidate is more stable and safer than midazolam on the effect of hemodynamics during induction of anesthesia in patients undergoing CABG surgery . Key words： Etomidate；Midazolam；Anesthesia induction；Hemodynamics；Bispectral index；Cononary artery bypass grafting 冠心病患者在麻醉诱导期最容易发生心肌缺血，导致血流动力学的急剧变化。依托咪酯具有起效快、作用时间短、对呼吸循环影响轻微，且对冠状动脉具有轻度的扩张作用，能增加心肌的氧供等优点，因此广泛应用于冠心病患者的麻醉诱导［1］。本文旨在对比依托咪酯和咪达唑仑在冠状动脉搭桥手术麻醉诱导期对脑电双频指数及血流动力学的影响。 1 资料与方法 一般资料 择期行冠状动脉旁路移植术患者46例，其中男性33例，女性13例，年龄（±）岁，体重（±）kg。术前有高血压23例，不稳定心绞痛8例，心肌梗死2例，慢性阻塞性肺病1例。术前心功能检查：左室射血分数（LVEF）41％～62％（±％）。冠状动脉造影结果显示左主干病变3例，单支病变3例，两支病变11例，3支病变29例。NYHA心功能分级：Ⅱ级32例，Ⅲ级14例。排除标准： LVEF40%，心肌梗死时间间隔小于1个月，术前血流动力学不稳定，急诊手术和二次手术的患者不入选。随机分成两组，即依托咪酯