摘要
目的 研究硬膜外麻醉对糖尿病病人自主神经功能的影响。方法 本文分析 18例Ⅱ型糖尿病病人硬膜外麻醉后的心率变异性 (heartratevariations,HRV) ,包括HRV指数 (HRVI)、低频功率 (LF)、高频功率 (HF)及LF/HF比值 ,并与 18例非糖尿病病人比较。结果 ( 1)糖尿病组硬膜外麻醉后的HRVI、LF及LF/HF均明显低于非糖尿病组 ;糖尿病病人麻醉后低血压发生率及窦性心动过缓发生率均高于非糖尿病组 ,且前者对阿托品反应较差。 ( 2 )HRVI与窦性心动过缓及低血压关系 :HRVI <3 0者 ,窦性心动过缓发生率高达 10 0 % ;而HRVI<4 0者 ,低血压发生率达 62 5 %。结论 糖尿病病人麻醉后出现的窦性心动过缓和低血压与HRVI有关。麻醉前的HRVI在一定程度上可预见术中病人循环功能的稳定性。
Objective To evaluate the effects of epidural anesthesia with 2% lidocaine and 0 3% tetracaine mixture on the functions of autonomic nervous system.Methods The heart rate variations index(HRVI),low frequncy(LF),high frequency(HF) and HF/LF ratio in 18 patients with typeⅡ dibetes mellitus were evaluated and compared with those in 18 cases without diabetes mellitus before and after epidural anesthesia.Results (1)The indexes of HRV,LF and LF/HF of diabetic group after epidural anesthesia were lower than those of control group.The incidence of hypotension and bradycardia with a poor response to atropine after epidural anesthesia was much higher in diabetic group than that in the control group.(2)The incidence of hypotension was as high as 62 5% in the patients with HRV<40.The bradycardia occured in all patients with preanesthesia HRV<30.Conclusion The incidence of hypotension and bradycardia in diabetic patients after epidural anesthesia is related to HRV index.The pre anesthesia HRV index might help to predict the circulation stability during anesthesia.
出处
《临床麻醉学杂志》
CAS
CSCD
2001年第8期416-418,共3页
Journal of Clinical Anesthesiology
