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目的研究静脉注射利多卡因在全麻诱导气管插管期间对老年冠心病患者自主神经系统功能的影响。方法 90例择期腹部手术老年冠心病患者,随机分为静注利多卡因1.5 mg/kg组(L组)和对照组(P组),每组45例。分别于麻醉前(T0)、麻醉诱导后(T1)及气管插管后(T2)用心率变异功率谱分析(HRPSA)技术观察患者的心率变异性(HRV)变化。结果 T1时两组HRV低频段(LF)、高频段(HF)、低频/高频(LF/HF)和总功率频段(TP)均显著降低(P<0.05),L组LF低于P组(P<0.05);T2时两组LF、HF、LF/HF及TP较T0、T1时均显著升高(P<0.05),T2时L组LF与LF/HF升高程度显著低于P组(P<0.05)。结论静注利多卡因能明显抑制插管操作引起植物神经功能的干扰,有利于维护老年冠心病患者围插管期心脏自主神经功能。
Objective To investigate the effects of intravenous lidocaine on autonomic nervous system function in elderly patients with coronary heart disease during tracheal intubation induced by general anesthesia. Methods 90 elderly patients with coronary heart disease undergoing elective abdominal surgery were randomly divided into intravenous lidocaine 1.5 mg / kg group (L group) and control group (P group), 45 cases in each group. The changes of heart rate variability (HRV) in patients before anesthesia (T0), after induction of anesthesia (T1) and after tracheal intubation (T2) were analyzed by heart rate variability power spectrum analysis (HRPSA). Results At T1, LF, HF, LF / HF and total power (TP) of HRV in both groups were significantly decreased (P <0.05), LF in L group was lower than that in P group (P <0.05). The levels of LF, HF, LF / HF and TP in both groups were significantly higher than those in T0 and T1 at T2 (P <0.05) Group (P <0.05). Conclusion Intravenous injection of lidocaine can significantly inhibit the disturbance of autonomic nerve function caused by intubation and is helpful for the maintenance of cardiac autonomic nerve function in the elderly patients with coronary heart disease.