尼卡地平和艾司洛尔联合应用对颅脑术后气管拔管者心血管的影响

Effect of nicardipine combined with a small-dose esmolol on cardiovascular responses to tracheal extubation following intracranial surgery

目的观察小剂量尼卡地平和艾司洛尔联合应用对颅脑术后气管拔管者心血管的影响。方法40例行开颅手术,随机分为A、B两组,每组20例。B组为生理盐水对照组,A组患者在术毕呼吸开始恢复时给予尼卡地平10～20μg/kg和艾司洛尔0.5～1mg/kg,静脉注射。所有患者均给药后15min予以拔管,分别观察手术结束给药前,给药后1,3,5,10,20min及拔管时收缩压、舒张压、心率的变化。结果A组患者静脉注射尼卡地平与艾司洛尔后约3,5,10,20min和拔管时收缩压、舒张压、心率均呈显著下降(P<0.01)。B组各项观察指标除给药后20min(拔管后)外无显著变化(P>0.05)。结论小剂量尼卡地平与艾司洛尔联合应用可预防围拔管期血压升高,并能弥补拔管时单独应用尼卡地平不能有效控制心率的不足,预防颅脑手术全麻后气管拔管时心血管反应。

Objective To observe the effect of nicardipine with small-dose esmolol on car-diovascular responses to tracheal extubation following intracranial surgery. Methods Forty patients undergoing intracranial surgery were randomly divided into group A receiving nicardipine 10～20 μg/kg plus esmolol 0.5～1 mg/kg at the beginning of breathing after operation, group B receiving normal saline as the control, respectively. Extubation was performed 15 minutes after the designated drug was intravenously administered. SBP, DBP, MAP and HR were observed at pre-administration, at extubation and 1, 3, 5, 10, 20 minutes after administration. Results SBP, DBP and HR was significantly lower than those of pre-administration in groupA (P<0.01), at extubation and 3, 5, 10, 20 minutes after administration. SBP, DBP and HR showed no change in group B(P>0 05), except 20 minutes after administration. Conclusion Nicardipine combined with a small-dose esmolol attenuates the cardiovascular responses to tracheal extubation following intracranial surgery.