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 cardiovascuiar responses of hypertension patients to tracheal extubation

作　　者：施宏垒 黄炎 

机构地区：[1]广东省汕尾市海丰县澎湃纪念医院麻醉科,广东海丰516400

出　　处：《中国当代医药》2009年第14期22-24,共3页China Modern Medicine

摘　　要：目的:探究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:选择术前己确诊高血压择期全麻手术的患者80例。随机分为A(对照组)组,B(倍他乐克0.02mg/kg)组,C(倍他乐克0.04mg/kg)组,D(倍他乐克0.06mg/kg)组。四组拔管前分别静注生理盐水5ml,倍他乐克0.02、0.04和0.06mg/kg(将倍他乐克稀释至5ml),记录患者入室时、拔管前lmin、拔管时、拔管后l、3、5、10min的脉搏血氧饱和度(SpO2)、心率(HR)、收缩压(SBP)、舒张压(DBP)。结果:A组拔管时及拔管后lmin,SBP、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lmin,SBP、DBP、HR和RPP显著低于A组(P<005);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lmin,SBP、DBP、HR和RPP显著低于A组(P<0.01),C、D组拔管5min,SBP、RPP显著低于给药前(P<0.05),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 5 ml saline（group A） metoprolol 0.02 mg/kg（group B）,0.04 mg/kg （group C）,0.06 mg/kg （group D） respectively and then the trachea was extubated later, systolic blood pressure（SBP）,diastolic blood pressure（DBP）and heartrate（HR） were recorded at premeditation,tracheal extubation, and 1,3,5 min after the tracheal extubation. Results： The SBP, DBP, HR, RPP of the patients in group A increased significantly at the tracheal extubation compared with pre-tracheal extubation （P〈0.01）, the SBP, DBP, HR, RPP of group C, D decreased significantly at the tracheal extubation compared with those in group A and B （P〈O.05）, and the SBP, DBP, HR, RPP of patients in group C, D decreased significantly at 1min after tracheal extubation compared with those of patients in group A（P〈0.01）.The SBP, HR, RPP in group C, D decreased significantly at tracheal extubation compared with those in group A and B （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）in group D had a bradycardia after receiving metoprolol. Conclusion： Metoprolol of 0.04 mg/kg may effectively control cardiovascular responses of high pressure patients to the tracheal extubation, and 0.04 mg/kg is the most safe.

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]