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目的 :观察异丙酚与依托咪酯麻醉诱导过程中血糖和皮质醇的变化 ,以评价两药物对应激反应的抑制作用。方法 :40例ASAⅠ～Ⅱ级行腹腔镜下胆囊切除术患者 ,随机分为异丙酚组 (A组 ,n =2 0 )和依托咪酯组 (B组 ,n =2 0 )。麻醉诱导A组异丙酚 2mg/kg、B组依托咪酯 0 4mg/kg ,加用芬太尼 2 μg/kg、阿曲库铵 0 5mg/kg。结果 :(1)诱导后血糖A组由 4 5 9± 0 6 7mmol/L增至 4 93± 0 6 3mmol/L ;B组由 5 0 4± 0 5 0mmol/L增至 5 6 7± 0 80mmol/L(P <0 0 5 )。 (2 )血皮质醇A组由 13 6± 5 17μg/L降至 10 4± 5 5 6 μg/L ;B组由 12 3± 5 18μg/L降至 8 37±4 13μg/L(P <0 0 5 )。 (3)诱导后 5分钟 ,A组BP、HR均明显下降 (P <0 0 5 ) ;而B组则上升 (P <0 0 5 ) ,10分钟后恢复至诱导前水平。结论 :异丙酚与依托咪酯均能抑制麻醉插管时的应激反应 ,但异丙酚比依托咪酯更为有效
Objective: To observe the changes of blood glucose and cortisol during the induction of propofol and etomidate to evaluate the inhibitory effect of two drugs on stress reaction. Methods: Forty ASA Ⅰ ~ Ⅱ patients undergoing laparoscopic cholecystectomy were randomly divided into propofol group (group A, n = 20) and etomidate group (group B, n = 20). Anesthetic induction of propofol group A 2mg / kg, B group etomidate 0 4mg / kg, plus fentanyl 2μg / kg, atracurium 0 5mg / kg. Results: (1) After induction, the blood glucose in group A increased from 499 ± 0 6 7mmol / L to 4 93 ± 0 6 3mmol / L, while that in group B increased from 504 ± 0 50mmol / L to 567 ± 0 80mmol / L (P <0 05). (2) The serum Cortisol level decreased from 13 6 ± 5 17 μg / L to 10 4 ± 5 5 6 μg / L in Group C, and decreased from 12 3 ± 5 18 μg / L to 8 37 ± 4 13 μg / L in Group B (P < 0 0 5). (3) After 5 minutes of induction, the BP and HR of group A decreased significantly (P <0.05), while those of group B increased (P <0.05), and returned to the level of pre-induction 10 minutes later. CONCLUSIONS: Propofol and etomidate both suppress the stress response during anesthesia intubation, but propofol is more effective than etomidate