美托洛尔对鼻内窥镜手术患者术后住院时间的影响

The Effect of Metoprolol on Postoperative Hospitalization Time of patients with Endoscopic Sinus Surgery

目的本研究拟通过鼻内窥镜手术中应用美托洛尔,观察β-肾上腺素受体阻滞剂对ASAⅠ～Ⅱ级患者术后住院时间的影响。方法气管内麻下行Fess手术患者80例。随机分为实验组和对照组(n=40)。临床观察组术前静脉推注美托洛尔15mg。对照组术中静脉泵注硝普钠。两组患者的麻醉用药一致,两组维持收缩压在80～90mmHg,平均动脉压大于50mmHg,比较两组患者术后住院时间、两组患者乳酸、血糖、血流动力学变化。结果1临床观察组术后住院时间为2～4天,平均(3.33±0.65)天,对照著组术后住院时间3～6天,平均(4.55±0.82)天。两组比较有显著性差异(P=0.001)。2两组患者手术开始后乳酸和血糖都逐渐升高,术后回落。两组患者乳酸(P=0.01)和血糖(P=0.00)的变化趋势明显不同。结论围术期应用美托洛尔能够通过抑制应激反应,缩短ASAⅠ～Ⅱ级患者的术后住院。

Objective The aim of our study is to find the effect of beta-adrenergicreceptor Blockade on postoperative hospitalization time during Endoscopic Sinus Surgery and to investigate its mechanism through the lactate and glucose fluctuation.Method Eighty patients, ASA Ⅰ～Ⅱ, undergoing endoscopic sinus surgery who fit the inclusion and exclusion criteria were randomly assigned to receive either a beta-blocker, Metoprolol （group M）, or a placebo （group C） 30 minutes before surgery. A standard anesthetic protocol was followed. Systolic blood pressure was kept in 80-90 mmHg in two groups perioperatively. Heart rate, blood glucose and arterial lactate were assessed during anesthesia and postoperative hospitalization time was compared after operation. Results 1. Postoperative hospitalization time in group M（3.33±0.65） was shorter than that in group C（4.55 ±0.82）. There was significant difference between two groups （P=0.001 （0.05）. 2 Compared with group C, the lactate and gluose level were steadier in group M. There was a significant difference between two groups. （P= 0.00〈0.05）3, There was significant difference in overall mean heart rate between group M and group C（P〈0.05）. Conclusion Metoprolol can decurtate ASA Ⅰ～Ⅱ patients＇ postoperative hospitalization time by inhibiting perioperative stress.