Comparing Hemodynamic Responses to Diazepam, Propofol and Etomidate During Anesthesia Induction in Patients with Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Graft Surgery: a Double-blind, Randomized Clinical Trial.
Comparing Hemodynamic Responses to Diazepam, Propofol and Etomidate During Anesthesia Induction in Patients with Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Graft Surgery: a Double-blind, Randomized Clinical Trial.
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DOI：
10.5455/medarh.2017.71.198-203
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发表时间：
2017-06-01
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影响因子：
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通讯作者：
Sohrabi, Fatemeh Bozorg
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文献类型：
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作者：
Soleimani, Aria;Heidari, Neda;Sohrabi, Fatemeh Bozorg
背景：麻醉诱导通常伴随着一段时间的血流动力学不稳定，这对于接受冠状动脉旁路移植术（CABG）的冠状动脉疾病（CAD）和左心室功能障碍患者可能是有害的。本研究的目的是比较低射血分数（EF）的CABG手术患者在麻醉诱导、喉镜检查和插管后对异丙酚、依托咪酯和地西泮的血流动力学反应。方法：对150例冠心病合并左心功能不全（EF≤35%）患者进行随机双盲临床研究，这些患者计划择期行CABG合并体外循环（CPB）手术。将患者随机分为A、B、c三组，分别给予异丙酚、依托咪酯、地西泮诱导麻醉。血流动力学变量（收缩压和舒张压[SBP， DBP]，平均动脉压[MAP]和心率[HR]）在基线、喉镜检查和气管插管前、插管后1分钟和3分钟测量并记录。结果：诱导后1分钟和喉镜检查前，三组患者收缩压、舒张压和MAP较基线均有统计学意义的下降，但地西泮组各血流动力学参数的这些变量均小于其他两组(p
BACKGROUND: Anesthesia induction is often accompanied by a period of hemodynamic instability, which could be deleterious in patients with coronary artery disease (CAD) and left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery. The aim of this study was to compare the hemodynamic responses to propofol, etomidate, and diazepam following anesthesia induction, laryngoscopy and intubation in CABG surgery patients with low ejection fraction (EF).METHODS: A double-blind randomized, clinical study was performed on 150 patients with CAD and left ventricular dysfunction (EF≤35%) scheduled for elective CABG surgery with Cardiopulmonary bypass (CPB). Patients were randomly allocated to three groups A, B, and C. These patients received propofol, etomidate or diazepam at induction of anesthesia, respectively. Hemodynamic variables (systolic and diastolic blood pressure [SBP, DBP], mean arterial pressure [MAP] and heart rate [HR]) were measured and recorded at baseline, immediately before laryngoscopy and tracheal intubation and one and three minutes after intubation.RESULT: One minute after induction and before laryngoscopy, there was a statistically significant decrease from the baseline in SBP, DBP and MAP in all three groups, but these variables in each hemodynamic parameters in diazepam group were less than other two groups (p