Haemodynamic changes and heart rate variability during midazolam-propofol co-induction
Haemodynamic changes and heart rate variability during midazolam-propofol co-induction
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DOI：
10.1111/j.1365-2044.2007.04990.x
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发表时间：
2007-06-01
期刊：
影响因子：
10.7
通讯作者：
Umino, M.
中科院分区：
文献类型：
--
作者：
Win, Ni Ni;Kohase, H.;Umino, M.
在一项前瞻性、盲法、随机研究中，我们检查了咪达唑仑-丙泊酚联合诱导对血液动力学（血压、心率和每搏输出量）和心率变异性的影响。后者通过光谱分析使用最大熵方法测量，以计算以下内容：反映心脏交感神经和副交感神经活动的低频分量（LF）、反映心脏副交感神经活动的高频分量（HF）和熵、通过LF和HF相加计算的总功率（TP）以及LF/HF比率，其反映了心脏交感神经和副交感神经活动之间的平衡。将40例患者随机分为丙泊酚组和咪达唑仑-丙泊酚组，分别于诱导前（T1）、诱导后（T2）、气管插管后（T3）、插管后3 min（T4）和5 min（T5）测定上述参数。丙泊酚组给予丙泊酚2.5 mg.kg（-1），咪达唑仑-丙泊酚组给予咪达唑仑0.1 mg.kg（-1），随后给予丙泊酚1.5 mg.kg（-1）用于麻醉诱导。然后，两组均以4-6 mg.kg（-1）丙泊酚维持给药。咪达唑仑-丙泊酚组显示出代偿性血流动力学变化，这与T2、T4和T5时LF/HF比值显著增加相关（p = 0.011、0.038和0.034）。这些结果表明，咪达唑仑-丙泊酚组合对心血管系统产生补偿性调节作用，包括保留压力反射活性。
In a prospective, blind, randomised study, we examined the effects of midazolam-propofol co-induction on haemodynamic (blood pressure, heart rate and stroke volume) and heart rate variability. The latter was measured by spectral analysis using the maximum-entropy method to calculate the following: the low frequency component (LF), which reflects both the cardiac sympathetic and parasympathetic activity, the high frequency component (HF) and entropy, which reflects the cardiac parasympathetic activity, the total power (TP), calculated by the addition of LF and HF, and the LF/HF ratio, which reflects the balance between the cardiac sympathetic and parasympathetic nervous activity. Forty patients were randomly allocated to the propofol group and the midazolam-propofol group, and the parameters described above were calculated at baseline (T1), post induction (T2), after tracheal intubation (T3), and 3 min (T4) and 5 min after intuba-tion (T5). Propofol was administered at 2.5 mg.kg(-1) in the propofol group and midazolam at 0.1 mg.kg(-1) followed by propofol at 1.5 mg.kg(-1) in the midazolam-propofol group for anaesthesia induction. Then, propofol was administered at 4-6 mg.kg(-1)propofol for maintenance in both groups. The midazolam-propofol group showed compensated haemodynamic changes, which were related to significant increases in the LF/HF ratio at T2, T4 and T5 (p = 0.011, 0.038 and 0.034). These results suggest that the midazolam-propofol combination yielded compensated modulatory effects on the cardiovascular system, including preserved baroreflex activity.