摘要
目的了解艾司洛尔复合硝普钠(SNP)对高血压患者全麻拔管时循环反应的影响。方法40例全麻患者随机分为对照组(A组)和观察组(B组),每组20例。麻醉前测收缩压(SBP)、舒张压(DBP)、心率(HR),并抽取血标本用高效液相色谱仪测血浆中去甲肾上腺素(NE)、肾上腺素(E)浓度为基础值。术毕待有拔管指征时,A组静注生理盐水0.5mL/kg;B组静注艾司洛尔0.5mg/kg,同时静滴SNP1μg/(kg·min),给药后2min两组都吸痰拔管。记录拔管时用药前、用药后2min、吸痰拔管即刻、拔管后1、5和10minSBP、DBP、HR,并计算收缩压-心率乘积(RPP);同时抽取拔管后1、5和10min血标本测NE、E浓度。结果A组吸痰拔管即刻及拔管后1、5min时SBP、DBP、HR、NE、E都显著增高(P<0.05);B组用药后2min时SBP、DBP、HR、RPP显著降低(P<0.01);吸痰拔管即刻、拔管后1、5和10min时SBP、DBP显著降低(P<0.05);拔管即刻、拔管后1、5min时HR、RPP显著降低(P<0.05);拔管后1、5和10minNE、E浓度显著降低(P<0.01)。结论艾司洛尔复合硝普钠可有效地缓解高血压患者全麻术毕拔管时的循环反应,提高拔管的安全性。
To study the Influences of esmolol-sodium nitroprusside mixture on extubation response in patients with hypertensin. Forty adult ASA Ⅰ, Ⅱ patients under general anesthesia were randomly divided into two groups of twenty patients each: Group A (control group) and group B (observing group). Before anesthesia the baseline systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured and recorded and first blood samples were taken for determination of norepinephrine (NE) and epinephrine(E)by high performance liquid chromatography. When postoperative extubation,group A received normal saline 0.5ml/kg intravenously;group B esmolol 0.5 mg/kg intravenously and SNP 1 μg/(kg·min) intravenous drip. After 2 min, suction and extubation were perform in two groups. At before drugs were given, after 2 min, just extubation, 1, 5 and 10 min after extubation SBP, DBP, HR were checked and recorded, and counted RPP. Blood samples were taken 1, 5 and 10 min after extubation for determination of NE and E. In group A, SBP, DBP, HR, RPP, NE and E increased significantly at just extubation, 1 and 5 min after extubation (P <0.05). In group B, SBP, DBP, HR and RPP decreased significantly at 2 min after drugs were given (P <0.01); SBP, DBP decreased significantly at just extubation, 1, 5 and 10 min after extubation (P <0.05); HR and RPP decreased significantly at just extubation, 1 and 5 min after extubation (P <0.05); NE and E decreased significantly at 1, 5 and 10 min after extubation (P <0.01). [Conclusions] Esmolol-sodium nitroprusside mixture is effective in reducing cardiovascular response to extubation in patients with hypertensin, improves the safe of extubation.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2005年第5期732-734,共3页
China Journal of Modern Medicine
关键词
艾司洛尔
硝普钠
高血压
全麻拔管
循环反应
esmolol
sodium nitroprusside
hypertensin
extubation
cardiovascular respons
