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  

作　　者：肖开颜[1] 单家媛[1] 罗玲[1] 

机构地区：[1]四川省凉山彝族自治州第一人民医院麻醉科,615000

出　　处：《当代医学》2010年第1期139-140,共2页Contemporary Medicine

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。方法将60例ASAI～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,A组静注艾司洛尔1mg/kg;B组静注乌拉地尔0.5mg/kg;C组静注艾司洛尔0.5mg/kg、乌拉地尔0.25mg/kg;D组静注生理盐水1ml/kg。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能更有效地控制气管导管拔管的心血管反应。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, t3, C, D）.Before the extraction of endotracheal tubes, group A were given Esmolol lmg/ kg, group B Urapidil 0.5mg/kg, group C Esmolol 0.5mg/kg and Urapidil 0.25mg/kg, group D with normal saline lml/kg. Detect a change in their ECG, SBP, DBP, HR, SpO2, PetCO2 and calculate the product of HR and SBP（RPP）. Results After the Removal of endotracheal tubes, $13P, DBP, HR and RPP in each group obviously increases （P〈0.05）.Compared with group D, SBP, DBP, HR and RPP in groups A, B, C were lower （P〈0.05）. Compared with group C, SBP and D13P in group A were higher （P〈0.05）, HR of group B was higher than that of group C （P〈0.05） and the RPP of groups A and B was also higher than that of group C （P〈0.05）. 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 The effects of combinative administration of Esmolol and Urapidil on cardiovascular response during tracheal intubation are very good.

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 

分 类 号：R614[医药卫生—麻醉学]