乌拉地尔预防颈丛阻滞麻醉后心血管副反应的临床观察

The Clinical Study of Urapidil on Preventing the Side Effect of Cervical Plexus Block on Cardiovascular Rresponse

目的 :探讨不同剂量的乌拉地尔预防颈丛阻滞麻醉后产生不良心血管反应的临床效果和安全性。方法 :6 6例ASAⅠ～Ⅱ级择期在颈丛阻滞麻醉下行甲状腺肿瘤手术的患者随机分为 3组 :A组 :2 2例。采用颈丛阻滞麻醉同时给予乌拉地尔 0 .6mg/kg静脉注射 ;B组 :2 2例。采用颈丛阻滞麻醉同时给予乌拉地尔 0 .3mg/kg静脉注射 ;C组 (对照组 ) :2 2例。采用颈丛阻滞麻醉同时给予生理盐水 3ml静脉注射。分别记录颈丛阻滞麻醉前 ,麻醉后 5min、10min、15min、2 0min、30min即刻收缩压 (SBP)、舒张压 (DBP)、心率 (HR)的值 ,观察麻醉效果。结果 :总有效率 :A组 95 .4 5 % (2 1/ 2 2 ) ,B组为 90 .91% (2 0 / 2 2 ) ,C组为 95 .4 5 % (2 1/ 2 2 ) ,3组比较 ,无显著性差异 (P >0 .0 5 ) ;SBP :B组麻醉后 15min、2 0min、30min与麻醉前比较 ,无显著性差异 (P >0 .0 5 ) ;DBP :B组麻醉后 5min、10min、15min、2 0min、30min与麻醉前比较 ,无显著性差异 (P >0 .0 5 ) ;A组麻醉后 5min、10minSBP、DBP较麻醉前明显下降 (P <0 .0 5 ) ,无一例低血压危象。C组麻醉后 5min、10min、15min、2 0minSBP、DBP较麻醉前明显上升 (P <0 .0 5 ) ;HR :A组麻醉后 10min、2 0min ,B组麻醉后 10min、15min、2 0min ,C组麻醉后 5min、10min。

Objective:To observe the clinic effect and safety of urapidil at an appropriate dose on preventing the side of cervical plexus block on cardiovascular response.Methods:Sixty-six patients undergoing selective surgery with anesthesia of cervical plexus block were randomly divided into three groups:Group A,Group B,and Group C.The patients in Group A were injected with urapidil of 0.6 mg/kg via vein during the course of the anesthesia,group B with urapidil of 0.3 mg/kg,and group C received normal saline 3 ml as the control.The values of SBP DBP HR were observed before the anesthesia,at 5 min,10 min,15 min,20 min,and 30 min after anesthesia in the three groups respectively.The anesthetic effect were evaluated.Results:There were no significant differences of anesthetic effects among the three groups.The rate of effect in group A reached 95.45%.and B group reached 90.91%,C group reached 95.45%.SBPs at 15 min,20 min,and 30 min after anesthesia in group A and 5 min,10 min,15 min,20 min,30 min after anesthesia in group B showed no significant difference compared with that of their own pre-anesthesia.SBP and DBP at 5 min and 10 min in group A were decreased compared with pre-anesthesia without an example of hypotension crisis.The values of HR at 10 min and 20 min in group A and 10 min,15 min,and 20 min in group B and 5 min,10 min,and 20 min in group C were more significantly increased than that of their own pre-anesthesia.Conclusion:The dose of 0.3 mg/kg of urapidil for preventing the rise of blood pressure during the induction of cervical plexus block is effective and safe.However,there is some deficiency for preventing the rise of HR.