在地氟烷浓度快速增加期间，艾司洛尔预处理可减少心率增加以及增强副交感神经抑制：一项初步的随机研究。
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Esmolol pretreatment attenuates heart rate increase and parasympathetic inhibition during rapid increases in desflurane concentration: A preliminary randomized study.
背景及目的：地氟醚浓度的快速增加可以暂时增加心率（HR）。 艾司洛尔具有高的β1-肾上腺素受体选择性和短的作用持续时间。 这项研究旨在探究艾司洛尔在地氟醚诱导的HR增加过程中对HR和自主神经调节的影响。
1
方法：选择ASA I级女性受试者，年龄在20至50岁，正在接受轻微乳房手术，被随机分配到2组。在麻醉诱导后开始快速增加地氟醚浓度，在地氟醚吸入之前，每个受试者都接受了静脉注射生理盐水（对照组）或艾司洛尔0.5 mg / kg（艾司洛尔组）。使用HR变异性的时频谱分析，在基线，诱导后，治疗后以及地氟醚的最小肺泡浓度达到1.0,1.3和1.5时研究HR指数。低频（LF）功率受交感神经和副交感神经活动的影响，而高频（HF）功率反映副交感神经活动。LF / HF比被认为反映了交感迷走神经平衡或交感神经调节。
结果：用于数据分析的心电图从每组8名受试者获得。 诱导后地氟醚浓度的快速增加导致HR增加。相应的LF和HF功率都很低，LF / HF比保持不变。这表明地氟醚诱导的HR增加可能归因于副交感神经抑制，并且可能与交感神经激活无关。艾司洛尔预处理有效减弱了地氟醚诱导的HR增加。此外，接受艾司洛尔预处理的受试者具有增加的LF和HF功率，但与没有艾司洛尔的那些相比，其LF / HF比率没有变化。
结论：艾司洛尔预处理减弱了地氟烷浓度快速增加期间的HR增加,加强了副交感神经抑制。
MC Kao ， ISTzeng ， HLChanEsmolol pretreatment attenuates heart rate increase and parasympathetic inhibition during rapid increases in desflurane concentration:A preliminary randomi 《Medicine》 , 2017 , 96 (42) :e83
Rapid increases in desflurane concentration can transiently increase the heart rate (HR). Esmolol possesses a high β1-adrenoceptor selectivity and a short duration of action. This preliminary study aimed at investigating the effects of esmolol on the HR and autonomic modulation during a desflurane-induced HR increase.METHODS American Society of Anesthesiologists physical status I female subjects, aged 20 to 50 years, who were undergoing minor breast surgery were randomly assigned to 2 groups. Rapid increases in desflurane concentration were commenced after induction of anesthesia. Each subject received either i.v. saline (control group) or esmolol 0.5 mg/kg (esmolol group) before desflurane inhalation. Using time-frequency spectral analysis of HR variability, the HR indices were studied at baseline, postinduction, posttreatment, as well as at minimal alveolar concentrations of desflurane reaching 1.0, 1.3, and 1.5. The low frequency (LF) power is influenced by both the sympathetic and parasympathetic activity, whereas the high frequency (HF) power reflects the parasympathetic activity. The LF/HF ratio is thought to reflect either sympathovagal balance or sympathetic modulation.RESULTS Electrocardiograms for data analysis were obtained from 8 subjects in each group. Rapid increases in desflurane concentration after induction caused a HR increase. Both the corresponding LF and HF powers were low and the LF/HF ratio remained unchanged. This indicates that the desflurane-induced HR increase may be attributed to parasympathetic inhibition and may be independent of sympathetic activation. Esmolol pretreatment effectively attenuated desflurane-induced HR increase. Moreover, subjects receiving esmolol pretreatment had increased LF and HF powers, but did not have changes in their LF/HF ratios, as compared to those without esmolol.CONCLUSION Esmolol pretreatment attenuates HR increase and parasympathetic inhibition during rapid increases in desflurane concentration.
麻醉学文献进展分享
联系我们