不同剂量艾司洛尔对硝酸甘油控制性降压影响的研究

Effect of different dosage of Esmolol on deliberate hypotention induced by Nidroglycerin

目的研究不同剂量艾司洛尔对硝酸甘油控制性降压的影响。方法选择24例行脑动脉瘤夹闭术的病人,随机分成三组:Ⅰ组为单纯硝酸甘油降压组(n=8);Ⅱ组为小剂量艾司洛尔(25μg.kg-1.min-1)复合硝酸甘油降压组(n=8);Ⅲ组为大剂量艾司洛尔(50μg.kg-1.min-1)复合硝酸甘油降压组(n=8)。记录诱导降压和停药后血压恢复时间。记录降压前即刻(T1)、降压达预定值(T2)、停止降压前即刻(T3)及血压恢复时(T4)的MAP和HR。结果Ⅱ组、Ⅲ组与Ⅰ组比较,降压达预定值(T2)、停止降压前即刻(T3)时的HR明显减慢(P<0.01);诱导降压时间、恢复血压时间显著缩短,维持降压硝酸甘油用量明显减少(P<0.01)。Ⅱ组和Ⅲ组之间的各项参数无统计学差异。结论艾司洛尔复合硝酸甘油进行控制性降压用于脑动脉瘤夹闭术病人降压效果确切,安全系数较大。

Objective： To study the effect of different dosages of Esmolol on deliberate hypotention induced by nidroglvcerin. Methods： 24 patients undergoing elective intracranial aneurismal clipping were randomly divided into three groups： nidroglycerin induced hypotension group （group Ⅰ, n = 8）; low dose esmolol （25 μg·kg^-1·min^-1） ＋ nidroglycerin induced hypotension group （group Ⅱ, n = 8）; large dose esmolol （50 μg·kg^-1·min^-1） ＋ nidroglycerin induced hypotension group （group Ⅲ, n = 8）. The time for blood pressure reduction and stopping medicine infusion （or return to norreal） was recorded. The mean arterial pressure（MAP） and heart rate （HR） were monitored just before blood pressure reduction （T1）, just blood pressure reduction to predetermined value （T2）, just before stopping blood pressure reduction （T3）, and just resuming blood pressure（T4）. Results： The HR of T2 and T3 in group Ⅱ and Ⅲ was decreased significantly than those in group Ⅰ. The time of induced hypotension, blood pressure reduction to predetermined value was shortened significantly, Nidroglycerin dosage maintaining hypotension was decreased significantly （P 〈 0.01）. There was no significant difference those in group Ⅱ compared with those in group Ⅲ. Conclusion： Esmolol and nidroglycerin controlled hypotension use for intracranial aneurysm clipping was effective and safe.