瑞芬太尼和硝普钠对兔鼻黏膜血流的影响  

Effects of sodium nitroprusside or remifentanil used in rabbits on nasal mucosal blood flow

作　　者：商丽梅[1] 李刚[1] 孙梅杰[2] 边雯[2] 

机构地区：[1]山东大学附属省立医院麻醉科 [2]山东大学附属省立医院西院麻醉科,济南250021

出　　处：《山东大学耳鼻喉眼学报》2011年第1期49-52,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：山东省自然科学基金资助(Y2008C25)

摘　　要：目的观察静脉持续泵入瑞芬太尼和硝普钠对兔鼻黏膜血流的影响。方法将20只新西兰大白兔随机分为瑞芬太尼组(R组)和硝普钠组(S组),每组10只。建立兔全麻模型后,R组静脉持续泵入瑞芬太尼,S组静脉持续泵入硝普钠,分别记录2组给药前及给药后新西兰大白兔的心率(HR)、平均动脉压(MAP)、颈总动脉血流(CABF)和鼻黏膜血流(NBF)。结果与给药前比较,R组HR减慢,MAP轻度下降,CABF轻度减少,NBF明显减少,且差异均有统计学意义(P<0.05);S组HR增快,MAP显著下降,CABF轻度减少,NBF明显增加,差异亦均有统计学意义(P<0.05)。给药后,S组比R组MAP下降幅度大(P<0.05);S组NBF明显增多,而R组NBF明显减少。S组同步监测的MAP与NBF呈负相关(r=-0.51,P<0.05),R组MAP与NBF间无明显相关性(P>0.05),2组MAP与CABF之间及CABF与NBF之间均无明显相关性(P>0.05)。结论与硝普钠相比,瑞芬太尼可显著减少鼻黏膜微循环血流,而对MAP和CABF影响轻微,提示选择瑞芬太尼用于鼻内镜手术的控制性降压更安全、有效。Objective To evaluate the effect of continuous infusion of sodium nitroprusside（SNP） or remifentanil on nasal mucosal blood flow in rabbits.Methods Twenty New Zealand white rabbits were randomly divided into the S group SNP-infusion（n=10） and the R group remifentanil-infusion（n=10）.After the anesthesia model of rabbit was established,SNP was infused in the S group and remifentanil was infused in R group.Heart rate（HR）,mean arterial pressure（MAP）,common carotid artery blood flow（CABF） and nasal mucosal blood flow（NBF） were measured during each period before and during infusion of SNP or remifentanil.Results In the R group,MAP,HR and CABF showed a mild decrease during infusion remifentanil,and NBF showed a significant decrease in the R group（P〈0.05）.In the S group,MAP and CABF showed a significant decrease during infusion SNP（P〈0.05）,whereas,HR and NBF showed a significant increase in the S group（P〈0.05）.The decreases in MAP measured as percent change were greater in the S group than in the R group.But the increases in NBF measured as percent change were greater in the S group than in the R group（P〈0.05）.A significant negative correlation was observed between MAP and NBF in the S group（P〈0.05）,however,little correlation was observed between MAP and NBF in the R group.In both groups,the correlation between MAP and NBF was not significant（P〉0.05）.Conclusion Infusion of remifentanil reduces NBF,without a major decrease in MAP and CABF and may be safer and more effective in endoscopic sinus surgery.

关 键 词：硝普钠 瑞芬太尼 鼻黏膜血流 颈总动脉血流 

分 类 号：R614.2[医药卫生—麻醉学]