硝酸甘油复合艾司洛尔控制性降压的可行性探讨

Controlled Hypotension with Nitroglycerin and Esmolol during Endoscopic Nasal Sinus Surgery

目的探讨鼻内镜手术患者应用硝酸甘油复合艾司洛尔控制性降压的可行性。方法选择ASA分级为Ⅰ级或Ⅱ级的择期鼻内镜手术患者30例,随机均分为两组,Ⅰ组静脉泵注硝酸甘油1～5μg/(kg·min),Ⅱ组予硝酸甘油+艾司洛尔[静脉负荷0.5μg/kg+泵注80μg/(kg·min)],两组均调整滴速至目标血压。结果与Ⅰ组相比,Ⅱ组达目标血压时间缩短,手术时间缩短,术野出血量评分降低(P<0.05);两组均无心血管不良事件发生。结论硝酸甘油复合艾司洛尔用于鼻内镜手术患者控制性降压安全、有效。

Objective To determine whether nitroglycerin combined with esmolol could induce and sustain controlled hypotension during endoscopic nasal sinus surgery and to evaluate the safety and feasibility. Methods Thirty ASA Ⅰ or Ⅱ patients were randomly divided into 2 groups. In groupⅠ ：nitroglycerin 1 -5 μg/（kg· min）, i. v,. In group Ⅱ：nitroglycerin 1 -5 μg/（kg· min） ＋ esmolol 0. 5 μg/kg ＋ 80 μg/（kg· min）, i. v.. Results The duration of operation was significant shorter in group Ⅱ than in group Ⅰ. MAP and HR were significantly lower in group Ⅱ than in group Ⅰ （P 〈 0. 05）. Conclusion Nitroglycerin combined with esmolol can be used to induce and sustain controlled hypotension during endoscopic nasal sinus surgery.