不同剂量倍他乐克对高血压患者全麻气管拔管时心血管反应的影响  

Effects of Different Doses of Metoprolol on Cardiovascular Responses of Hypertension Patients at the Tracheal Extubation

作　　者：敖斌[1] 刘雁[1] 

机构地区：[1]辽宁省大连市中心医院麻醉科,辽宁大连116033

出　　处：《中国现代医生》2009年第9期11-13,共3页China Modern Doctor

摘　　要：目的观察不同剂量倍他乐克注射剂在抑制高血压患者气管拔管心血管不良反应中的影响。方法选择术前已确诊高血压,择期全麻下手术患者80例。将之随机分为A组(对照组),B组(倍他乐克0.02mg/kg组),C组(倍他乐克0.04mg/kg组),D组(倍他乐克0.06mg/kg组)。记录患者入室时、拔管前1min、拔管时、拔管后1、3、5、10min的脉搏血氧饱和度、心率、收缩压、舒张压的数据,并计算出各时间点心率和收缩压的乘积(RPP)。结果A组拔管时及拔管后1minSBP、DBP、HR和RPP显著高于给药前(P<0.01);B组拔管时SBP、DBP、HR和RPP显著高于给药前(P<0.01),拔管后1minSBP、DBP、HR和RPP显著低于A组(P<0.05);C、D两组拔管时SBP、DBP、HR和RPP显著低于A、B两组(P<0.05),拔管后1minSBP、DBP、HR和RPP显著低于A组(P<0.01);C、D组拔管5minSBP、RPP显著低于给药前(P<0.05),但D组有2例用药后发生严重心动过缓。结论静注倍他乐克0.04mg/kg对高血压患者气管拔管时的心血管反应影响效果较好且安全性更大。Objective To observe the effects of different does of metoprolol on cardiovascular responses of hypertension patients at the tracheal extubation. Methods The 80 patients were randomly divided into 4 groups undergoing elective surgery. Before the tracheal extubation, patients received 5mL saline（group A）,metoprolol 0.02mg/kg（group B）,0.04mg/kg（group C）,0.06mg/kg（group D）respectively and then the trachea was extubated 5min later, systolic blood pressure, diastalic blood pressure and heart rate were recorded at premeditation, tracheal extabatian,and 1,3,Smin after the tracheal extubation. Rate-pressure product was derived from SBP× HR. Results The SBP,DBP,HR and RPP of the patients in group A increased significantly at the tracheal extubation compared with those in group A （P〈0.01）,The SBP,DBP,HR and RPP of patients in group C,D decreased significantly at the tracheal extubation compared with those in group A and B（P〈0.05）,and the SBP,DBP,HR and RPP of patients in group C,D decreased significantly at lmin after tracheal extubation compared with those of patients in group A（P〈 0.01 ）. The SBP, HR and RPP in group C, D decreased significantly at 3min after the tracheal extubation compared with those in group A（P〈 0.05 ）. Compared with premeditation,the SBP,RPP in group C,D decreased significantly at 3-5 min after the tracheal extubation （P 〈 0.05）, but two patients in group D had a bradycardia after receiving metoprolol. Conclusion Metoprolol of 0.04mg/kg and 0.06mg/kg may effectively control cardiovascular responses of high pressure patients to the tracheal extubation,but 0.04 mg/kg is safest.

关 键 词：倍他乐克 气管拔管 心血管反应 

分 类 号：R544.1[医药卫生—心血管疾病]