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The reaction of background and Objective To stress or stress the is to refers to the the the body subject to the hurt sexual stimulation, such as as trauma, loss of blood, hypoxia, pain, hot and cold, fear, strenuous exercise, the acute infection and surgical anesthesia, etc., lead to in order to the sympathetic nervous excitement, and pituitary - the an increase in adrenal cortex to secrete the the a series of nerve endocrine reaction consisting mainly of, and therefrom while the caused by the the the process of of the a variety of the function and metabolic of changes in of the the body's. Stress on the the the treatment of of the surgery the patient's diseases, has a important the impact of in the the after healing, and vested, has been growing subject to the attach importance to of people's. The thoracotomy esophageal cancer radical mastectomy the Frequently Asked surgery of the is the College of Chest, the its trauma is compare large, can be lead to a the body obvious stress reaction, the a strenuous of the stress response will give the body bring serious of the metabolic and endocrine disorders to. Therefore, how to reasonable regulation and control the stress response increasingly subject to the Concerned about the of the of narcotic the doctor's. But so far, For the to the the the startup of the stress response, strengthen, sustained, and perfect the the the body to on the the the the the exact mechanism of of the stress in of the to adapt to is still also did not completely understand that. How to reduce the the the the stress response in the surgery the process of in the of the and its the the caused by of the cardiovascular reaction is the one of the of the the select the anesthesia method on the in the clinical, the the an important basis for of the the anesthesia drugs of the. Reaction against the the the the stressors of the the perioperative period the some scholars to study of more is the in the the the intubation period under general and the during tracheal extubation period in the application of the inhibition of by the the a a variety of of different the drugs and methods of to the the the stress response of caused by out of the intubation and extubation of of the. While the the some of the operation in the in the-operative the same will caused by the strenuous of the stress reaction, and the of the stimulate the-sustained the time of the surgery is relatively long, but few people to research For the the stress reaction in the in the-operative. Esmolol is the the selective β 1 - adrenergic receptor blockers, onwards the rapid onset of action, the the role of time is short, is a very suitable for vasoactive drugs of the in the the the perioperative period application of of the, In a recent of the the research in has become widely accepted. At present, the its application of is multi-limited to the when the the intubation and extubation or as a kind of control the the of the temporary medication of of the heart rate and blood pressure in the the surgery, in For the to sustained infusion the on the the affect the of the the stress the reaction of the of the the perioperative period at home and abroad in the the surgery rarely reported. The and plasma ACTH, Cor, of Ang Ⅱ, and blood sugar the concentration of is, respectively, is to reflect the the the of the commonly used indicators of changes in by the stress response under the hypothalamus - pituitary - adrenal gland cortex system, renin - angiotensin - aldosterone system and metabolic and other aspects. The blood dynamics indicators is the the external manifestations of of the catecholamine the role of, can be used to indirect the estimated the the the function of state of of the sympathetic - adrenal medulla system. Is the to reflect the the the the a good indicator of of of the \The purpose of In this study, is to to by observing the esmolol the Continuing infusion on the thoracotomy esophageal cancer of plasma ACTH of the in Patients Undergoing Radical, the Cor, Ang Ⅱ and blood sugar the concentration of and the the the impact of of the blood dynamics changes in, for the the perioperative period reasonable application of esmolol to provide a theoretical basis. , Elective of rows thoracotomy, material and Methods 60 patients with, esophageal cancer to radical mastectomy in patients with, to were randomly divided into the A, B, C3 group use the random digital Table, be divided into groups of 20 cases of for. The A group was control group, B group as the experimental 1 group of, the C group for the experimental group 2. Group B, the C group of patients in the the the burglary, and opening up intravenous after the the intravenous pump Note hydrochloric acid esmolol Injection, pump Note speed of the B group for the 30μg · kg -1 · min -1 , C-the of the pump Note of speed of of the group for the the 50μg · kg -1 · min -1 , until the the end of surgery, the control group does not medication. A, B, C3 group are in the the intubation and 5min of the slow intravenous injection of in the prior to extubation, diluted to a 10mg/ml of the the esmolol 0.5mg/kg. 3 group of patients preoperative 30min intramuscular injection of midazolam 0.04mg/kg, atropine 0.5mg. Induction of the in turn intravenous injection of imidazole stability and 0.1mg/kg, fentanyl 3 ~ 5μg/kg, of propofol 2mg/kg, succinylcholine 1 ~ 1.5mg/kg, be inserted by mouth photopic a Robershaw double-lumen left into the bronchial catheter. Intravenous injection of-dimensional library bromine ammonium 0.1mg/kg. , Of propofol, intraoperative, 100μg · kg -1 · min -1 , fentanyl 1 ~~ 2μg · kg -1 h -1 the pump Note,-dimensional library bromine ammonium intermittent intravenous injection of to maintain anesthesia. In the the blood pressure those with normal in the intraoperative SBP lower than the 80mmHg or high blood pressure those who SBP reduce the the the the basis of value 20% in the for more than preoperative given for the the hypotension, HR <55 in the intraoperative times / min given for the the bradycardia. Hypotension the continued for more than 3 minutes when the application of ephedrine 5mg intravenous injection of, application of the atropine 0.2 ~ 0.3mg intravenous injection of when the the in the HR <55 times / min. Intraoperative the Bank of China mechanical ventilation, to to maintain the the end-expiratory carbon dioxide partial pressure (PetCO 2 ) 35 ~ mmHg to 45 mmHg by. , Respectively, records the 10min (T 0 ), the during intubation (T 1 ), the when the skin was cut (T 2 ), in the 3 group of in patients with after the burglary, the after the start of of surgery 30min (T 3 ), the after the start of of surgery 60min (T 4 ) and blood in the the time of extubation (T 5 ) of the dynamics The indicators and calculate the the the heart rate systolic blood pressure the product of (RPP). And, respectively, in the T 0 , T 2 , T 4 specimens from and the T 5 of each point-in-time venous blood samples , measured of ACTH of the by RIA method, Cor and Ang Ⅱ the concentration of, blood glucose meter measured blood sugar value. Records the in each group in patients with surgery time, the the amount of loss of blood in the intraoperative, rehydration the the amount of and urine output of, ST--segment display of the myocardial ischemia cases of the number of (ST segment depress the more than 0.1mV or ST-segment elevation more than 0.2mV sustained 1min or more think that there are myocardial ischemia occurrence of) atropine and of ephedrine have in the the in the, intraoperative use the cases of the number of. Statistically processing: all Measurement data were were expressed as mean poor standard of number of with disabilities ((?) ± s) expressed, the use of that the SPSS 11.0 Statistical Package for to carried out the statistical treatment. The the the blood dynamics indicators and the the stress used for indicators for to repeat measurement the data variance analysis of, twenty-two was used to compare the to The smallest significantly differential t-test. Used for indicators for of the of age, The body weight and an surgery time, and, etc. the single-factors analysis of variance. Count data using x 2 Inspection. P <0.05 difference was statistically significant. 1 the 3-group of in patients with of the the general situation age, was no statistically difference between the (P> 0.05) in the the the infusion types of, the the amount of the infusion the amount of loss of blood and urine output group of the gender, body weight, ASA physical status, surgery time, intraoperative inter-compare. 3 group of patients non-the 1 cases in the the intraoperative is appear awareness. 2 blood dynamics changes in the the 2.1 HR, SBP, and RPP changes in: 3-group of in patients with HR, SBP, and RPP in the T 0 the comparison between groups was no statistically difference between the (P> 0.05). 2.1.1 HR changes in: group within the compare: the A group HR in the T 1 , T 5 with the T 0 compare elevated obvious ( P <0.05); the HR intraoperative of the the B group and the group C the changes in is the smaller, group compare differences in within the the was no statistically significance (P> 0.05). Comparison between groups: the the A group HR at T 1 ~~ T 5 with the group C difference between the there are a statistically significance (P <0.05), the the the A group HR is higher than the group C. The group B and the group A, inter-the B group and the C group group compare differences in that no statistical significance. 2.1.2 SBP changes in: group within the compare: the A group SBP in the T 1 , T 5 with the T 0 compare elevated obvious ( P <0.05); in the the B group and the C group SBP intraoperative the changes in is the smaller, group compare differences in within the the was no statistically significance (P> 0.05). Comparison between groups: the A group SBP in the T 1 , T 5 with the group C have more statistically differences in (P <0.05), the A group SBP in the T 1 , T 5 higher than the group C. The the group B and the the A group, B group, and C group SBP in the the T 1 , T 5 comparison between groups was no difference in statistically significance. 3 group of SBP in the T 2 , T 3 , T 4 comparison between groups was no difference in statistically significance (P> 0.05). 2.1.3 RPP changes in: within-group comparisons: A group RPP in the T 1 , T 5 with the T 0 compare elevated obvious ( P <0.05); in the the B group and the C group RPP intraoperative the changes in is the smaller, group compare differences in within the the was no statistically significance (P> 0.05). Comparison between groups: the the A group RPP at T 1 ~~ T 5 with the group C difference between the there are a statistically significance (P <0.05), the the the A group RPP is higher than the group C. The group B and the group A, inter-the B group and the C group group compare differences in that no statistical significance. 2.2 myocardial ischemia the incidence of: A group have 2 (2/20) occurrence of the acute myocardial ischemia in the the in the patients with intraoperative, B-the group and C of-group None one cases occurrence of (P> 0.05).. 2.3 hypotension the incidence of: C group there are the 2 cases of (2/20) the intraoperative of patients with a result of hypotension application of the ephedrine. A group and group B have their own 1 cases (1/20) a result of hypotension application of the ephedrine in the the in the in patients with intraoperative. 2.4 bradycardia the incidence of: There was no one cases in patients with heart rate lower than the 55 times / sub-. In the in the a 3-group of intraoperative 3. And plasma ACTH, Cor, of Ang Ⅱ and blood sugar of the changes in the situation of 3.1. Of the changes in the situation of of the ACTH: 3 group of in patients with ACTH in the inter-the group of of each point-in-time compare was no difference in statistically significance (P> 0.05). 3 groups ACTH in the T 4 , T 5 In than the to T 0 elevated, differences in there are statistically significance (P <0.05). 3.2. The Cor of the changes in the situation: the 3-group of in patients with Cor in the inter-the group of of each point-in-time compare differences in was no statistically significance (P> 0.05). 3 groups Cor in the T 4 , T 5 In than the to T 0 elevated, differences in there are statistically significance (P <0.05). 3.3. The of the changes in the situation of of the Ang Ⅱ: the A group Ang Ⅱ in the T 4 , T- 5 compared with T 0 elevated the obvious (P <0.05), B group and the The the changes in of the group C Ang Ⅱ in the the at each time point the difference was not the statistically significance (P> 0.05). Comparison between groups: Ang Ⅱ, the B group and the group C, in the T 4 , T 5 than the A group the the corresponding point-in-time low-, the difference was there are statistically significance (P <0.05). 3.4. The of the changes in the situation of the blood sugar: the 3-group of in patients with blood sugar in the inter-the group of of each point-in-time compare differences in was no statistically significance (P> 0.05). 3 group of blood glucose in the T 4 , T 5 In than the to T 0 elevated, differences in there are statistically significance (P <0.05). Conclusion 1. Esmolol lol, 50μg · kg -1 · min -1 continuous infusion of and in the the intubation and extubation the the former intravenous injection of 0.5mg/kg be able to reduce the the intubation and Stubbs the tube stimulate the caused by of the the faster heart rate and blood pressure elevated, and, etc. blood dynamics fluctuations in, so that that the the anesthesia and surgery of the process blood dynamics a smooth, maintenance the balance of the the of muscle oxygen supply and demand of the surgical center. 2. Esmolol lol, 50μg · kg -1 · min -1 continuous infusion of and in the intubation and extubation the the former intravenous injection of 0.5mg/kg be able to inhibition of the anesthesia surgical stress caused by the elevated of Ang Ⅱ; but on the the the ACTH, Cor, and elevated blood sugar there is no affect the. 3. Esmolol lol, 30μg · kg -1 · min -1 continuous infusion of and in the the intubation and extubation the the former intravenous injection of 0.5mg/kg also be able to to inhibition of the anesthesia surgery to should be stimulated caused by the elevated of the Ang Ⅱ; but in the the the maintenance intraoperative the the blood dynamics stable aspects of is is is not enough ideal.
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