硝酸甘油或硝普钠复合艾司洛尔用于控制性降压对兔椎静脉血流的影响  

Effects of nitroglycerin and sodium nitroprusside plus esmolol for controlled hypotension on the blood flow of the vertebral vein in rabbits

作　　者：张光英[1] 郑若芳 韦秋凤[1] 林成新[1] 

机构地区：[1]广西医科大学第一附属医院麻醉科,南宁市530021

出　　处：《临床麻醉学杂志》2017年第2期176-178,共3页Journal of Clinical Anesthesiology

基　　金：广西自然科学青年基金项目(2014jjBA40070)

摘　　要：目的观察控制性降压时兔椎静脉血流的变化,探讨不同控制性降压方法对椎静脉血流的影响。方法成年健康新西兰兔18只,随机分为三组,每组6只。S组维持MAP于(90±5)mm Hg。GTN组采用硝酸甘油0.5μg·kg^(-1)·min^(-1)、艾司洛尔2.5μg·kg^(-1)·min^(-1)(硝酸甘油∶艾司洛尔为1∶5的复合液)行控制性降压,将MAP降低至基础值的(70±10)%。SNP组采用硝普钠0.5μg·kg^(-1)·min^(-1)、艾司洛尔2.5μg·kg^(-1)·min^(-1)(硝普钠∶艾司洛尔为1∶5的复合液)行控制性降压,将MAP降至同一目标值。于静脉全麻下建立控制性降压模型,采用Terason 2 000彩色超声系统分别在降压前、降压稳定后1h测量兔椎静脉血流量。结果降压前三组MAP分别为:S组(89.0±5.2)mm Hg,GTN组(91.5±9.6)mm Hg,SNP组(92.0±5.7)mm Hg,组间差异无统计学意义。S组实验前后血压无明显变化;GTN组与SNP组降压后血压差异无统计学意义,但均比降压前明显下降(P<0.05)。控制性降压后,GTN组与SNP组椎静脉血流量明显少于S组,GTN组明显少于SNP组(P<0.05)。结论在本实验选定的药物配比剂量内,硝酸甘油复合艾司洛尔比硝普钠复合艾司洛尔能更有效地降低椎静脉血流,可能更适用于脊柱手术的术中控制性降压。Objective To explore the effect of different controlled hypotension method on the blood flow of the vertebral vein by measuring of blood flow of vertebral vein in rabbits.Methods Eighteen New Zealand rabbits,weighing 2-3kg,were rando mly divided into three groups（n=6each）.Group S maintained MAP（90±5）mm Hg,group GTN reduced MAP to the base value of（70±10）% by using nitroglycerin 0.5μg·kg-1·min-1 and esmolol 2.5μg·kg-1·min-1（nitroglycerin∶esmolol=1∶5）,group SNP reduced MAP to the base value of（70±10）% by using sodium nitroprusside 0.5μg·kg-1·min-1 and esmolol 2.5μg·kg-1·min-1（sodium nitroprusside∶esmolol=1∶5）.The controlled hypotension model was established after intravenous general anesthesia.The blood flow of vertebral vein in rabbits were measured by ultrasonic measurement system（Terason2 000system）before controlled hypotension and 1hour after controlled hypotension.Results The MAP before controlled hypotension in group S（89.0±5.2）mm Hg,group GTN（91.5±9.6）mm Hg,group SNP（92.0±5.7）mm Hg had no significant difference.The blood pressure before and after the experiment had no significantly difference in group S.The blood pressure after controlled hypotension had no significant difference in group GTN and group SNP,but lower than that before controlled hypotension（P〈0.05）.Compared with group S,the blood flow of vertebral vein in group GTN and group SNP were significantly reduced（P〈0.05）.The blood flow in group GTN was significantly reduced compared with that in group SNP（P〈0.05）.Conclusion In the experiment,the combination of nitroglycerin and esmolol can better reduce blood flow of vertebral vein than that of nitroprusside and esmolol,that it is suitable for the control of hypotension in spinal surgery.

关 键 词：控制性降压 血流 椎静脉 兔 

分 类 号：R614[医药卫生—麻醉学]