乌拉地尔芬太尼预防气管插管时心血管反应的观察  

The Effect of Urapidil Fentanyl on Circulatory Response and ANP to Endotracheal Intubation

作　　者：陈淼[1,2] 戴克波[1,2] 余志豪[1,2] 蒋庆芳 曾红波[1,2] 吕忠容[1,2] 

机构地区：[1]贵州省遵义医学院麻醉科 [2]贵州省遵义医学院同位素科

出　　处：《临床麻醉学杂志》1998年第3期23-24,共2页Journal of Clinical Anesthesiology

摘　　要：目的：以测血压和脉搏为直接观察指标，测心钠素（ＡＮＰ）为间接观察指标，对比观察两种药物降低插管时的高循环动力的效果。方法：２０例择期肿瘤手术病人，随机分为两组：Ａ组用芬太尼２μｇ／ｋｇ，Ｂ组用乌拉地尔０．５ｍｇ／ｋｇ，于麻醉诱导前５ｍｉｎ应用。分别在术前、用药后５ｍｉｎ，插管后（０ｍｉｎ、５ｍｉｎ、１０ｍｉｎ）测血压、心率并分别抽静脉血测ＡＮＰ。结果：Ａ组用药后ＤＢＰ及ＡＮＰ降低，气管插管后ＡＮＰ恢复，但ＳＢＰ和ＤＢＰ均有升高。Ｂ组用药后ＤＢＰ和ＡＮＰ降低，插管后即刻血压稳定，与Ａ组比较差异有非常显著意义（Ｐ＜０．０１），ＡＮＰ在用药后及插管后即刻有降低，但迅速恢复，心率与术前比较差异有显著性意义。结论：乌拉地尔预防气管插管时心血管反应较小剂量芬太尼有效。Objective:To observe the effect of urapidil and fentanyl on the changes of plasma concentration of atrial natriuretic polypeptide (ANP) and circulatory respone to endotracheal intubation. Methods: 20 adult tumour patients, ASA grade ⅠⅢ, sheduled for selective surgery in general anesthesia were randomly assigned to receive fentanyl 2 μg/kg iv (group A) or urapidil 05mg/kg iv (group B) 10min before induction. SBP, DBP and HR were tested preoperatively, 5min after administering fentanyl or urapidil, at the time of intubation, 5 and 10min following intubation respectively. Venous blood samples for ANP measurment were also taken at the same interval. Results: In group A, the level of ANP and DBP decreased significantly (P<005)at 5min after drug administration. ANP. recovered while DBP remained high after intubation; In group B, DBP reduced at 5min after administration and became stable after intubation compared with group A(P<001). ANP lowered after urapidil and intubation. Both BP and ANP recovered rapidly. No more changes were seen in HR in the two groups. Conclusion: urapidil may have a better effect on circulactory depression and ANP response to endotrachea intubation than fentanyl.

关 键 词：乌拉地尔 芬太尼 心钠素 气管插管 循环 

分 类 号：R768[医药卫生—耳鼻咽喉科]