摘要
目的探讨乌拉地尔与硝酸甘油对全身麻醉鼻内窥镜手术患者每搏量变异度(SVV)的影响。方法选取2018年3月-2018年9月择期在全身麻醉下行鼻内窥镜手术患者60例。根据应用药物不同分为对照组、乌拉地尔组和硝酸甘油组,每组20例。对照组不给予降压药物,乌拉地尔组和硝酸甘油组于手术开始时给予相应降压药物。分别记录患者手术时间、术中出血量,并比较3组入室时(T0)、控制性降压即刻(T1)、10min(T2)和30min(T3)时的心率(HR)、平均动脉压(MAP)、心指数(CI)和SVV,并观察不良事件发生情况。结果乌拉地尔组和硝酸甘油组术中出血量和手术时间较对照组减少(P<0.05)。T2和T3时,乌拉地尔组和硝酸甘油组的MAP均低于对照组以及T0和T1时(P<0.05),硝酸甘油组HR高于对照组和T1时(P<0.05)。T3时,乌拉地尔组和硝酸甘油组SVV高于对照组和T1时(P<0.05),硝酸甘油组HR高于T0时(P<0.05)。3组均无严重不良事件发生。结论应用乌拉地尔与硝酸甘油后SVV值升高,可能是低估了患者的容量状态,影响了SVV的准确性。
Objective To investigate effect of Urapidil and Nitroglycerin on stroke volume variation (SVV) in patients undergoing nasal endoscopic surgery under general anesthesia. Methods A total of 60 patients undergoing selective endoscopic nasal surgery under general anesthesia from March to September 2018 were divided into control group, Urapidil group and Nitroglycerin group ( n =20 in each group) according to different medications. Control group did not be treated with antihypertensive drug, while antihypertensive drugs were implemented at the beginning of surgery in Urapidil and Nitroglycerin groups. Operative times and intraoperative bleeding volumes were recorded, and heart rate (HR), mean arterial pressure (MAP), cardiac index (CI) and SVV at the time of entering operating room (T0), at the time of deliberate hypotension (T1), after 10 min of deliberate hypotension (T2) and after 30 min of deliberate hypotension (T3) were compared, and incidence rates of adverse events were also recorded among three groups. Results Intraoperative bleeding volume and operative time in Urapidil and Nitroglycerin groups were significantly reduced compared with those in control group ( P <0.05). MAP levels at T2 and T3 in Urapidil and Nitroglycerin groups were significantly lower than those in control group and at T0 and T1 in the same groups ( P <0.05). HR level in Nitroglycerin group was significantly higher than those in control group and at T1 in the same group ( P <0.05). SVV levels at T3 in Urapidil and Nitroglycerin groups were significantly higher than those in control group and at T1 in the same groups ( P <0.05). HR level at T3 was significantly higher than at T0 in Nitroglycerin group ( P <0.05). No severe adverse events were found among three groups. Conclusion SVV can be increased after using Urapidil and Nitroglycerin, and it maybe affects accuracy of SVV for evaluation patients' volume state.
作者
石惠
王金保
底妍
张在旺
SHI Hui;WANG Jin-bao;DI Yan;ZHANG Zai-wang(Chengde Medical College,Chengde,Hebei 067000,China;Department of Anesthesiology,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China)
出处
《解放军医药杂志》
CAS
2019年第6期107-111,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省医学科学研究重点课题计划(ZD20140207)
