艾司洛尔和乌拉地尔联合用药预防气管拔管心血管反应的观察.docVIP

艾司洛尔和乌拉地尔联合用药预防气管拔管心血管反应的观察 四川省凉山州第一人民医院麻醉科 肖开颜 单家媛 罗玲 摘要 目的： 观察艾司洛尔和乌拉地尔联合用药预防气管插管心血管反应的临床效果。方法：60例ASA I～II级无心血管疾病拟在经口气管插管全麻下手术病人，随机平均分为四组（A.B.C.D.组）。于气管导管拔除前静注A组艾司洛尔1mg/kg，B组乌拉地尔0.5mg/kg，C组艾司洛尔0.5mg/kg、乌拉地尔0.25mg/kg，D组生理盐水1ml。所有患者连续监测心电图(ECG)、收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO2)和呼气末二氧化碳分压(PetCO2),并计算心率和收缩压乘积(RPP)。结果：拔管即时，四组SBP、DBP、HR、RPP值均明显升高(P＜0.05)；与D组比较，A组、B组、C组SBP、DBP、HR、RPP值低于D组(P＜0.05)；与C组比较，A组SBP、DBP高于C组(P＜0.05)，B组HR高于C组) (P＜0.05)，A组和B组RPP值高于C组(P＜0.05)；拔管后1min、5min、10min，四组SBP、DBP、HR、RPP值逐步下降至用药时水平，其中A组HR下降最快，B组SBP、DBP下降最快，C组RPP值下降最快。结论：联合应用艾司洛尔和乌拉地尔更能有效控制气管导管拔管的心血管反应。 关键词：艾司洛尔；乌拉地尔；联合用药；气管导管拔管；心血管反应 Effects of Combinative Administration of Esmolol and Urapidil on Cardiovascular Response during Tracheal Intubation [Abstract] Objective To observe the clinical effects of combinative administration of Esmolol and Urapidil on cardiovascular response during tracheal intubation . Methods Sixty patients with ASA grade Ⅰ-Ⅱ of non-cardiovascular disease to be endotracheal intubation under general anesthesia were randomly divided into four groups(A.B.C.D).Before the extraction of endotracheal tubes， group A were given Esmolol 1mg/kg, group B Urapidil 0.5mg/kg, group C Esmolol 0.5mg/kg and Urapidil 0.25mg/kg, group D with normal saline 1ml. Detect a change in their ECG、SBP、DBP、HR、SpO2、PetCO2 and calculate the product of HR and SBP(RPP).fter the Removal of endotracheal tubes , SBP、DBP、HR and RPP in each group obviously increases (p0.05).Compared with group D, SBP、DBP、HR and RPP in groups A、B、C were lower (p0.05). Compared with group C, SBP and DBP in group A were higher (p0.05), HR of group B was higher than that of group C (p0.05) and the RPP of groups A and B was also higher than that of group C (p0.05). 1,5 and 10 minutes after extraction, the SBP、DBP、HR and RPP of four groups gradually dropped to the level before treatment .Among them, HR of group A, SBP and DBP of group B, and RPP of group C dropped the most quickly. Conclusion