乌拉地尔预防颈丛阻滞心血管应激反应的临床研究

Clinical study of the prevention effect of urapidil to the cardiovascular stress in cervical plexus blockade patients

目的观察乌拉地尔和利多卡因配伍对颈丛阻滞心血管应激反应的防治作用。方法选择40例甲状腺类手术患者,随机分为两组各20例。所有患者均以C4一针法阻滞,阻滞液为A组1.25%利多卡因液30ml,B组1.25%利多卡因+乌拉地尔0.4～0.5mg/kg混合液30ml。两组患者均常规鼻导管吸氧,切皮前静脉注射芬太尼0.1mg和氟哌利多5mg。持续监测心电图、SpO2、血压,并在各时点抽血查血浆去甲肾上腺素(NE)和肾上腺素(E)的含量。结果B组患者阻滞前各观察指标无变化(P>0.05);A组患者阻滞后5、10min较阻滞前和B组间有明显变化(P<0.01)。血浆NE和E,A组阻滞后较阻滞前和B组间有变化(P<0.05)。结论乌拉地尔配伍利多卡因能有效地抑制颈丛阻滞后交感神经活性增强引起循环系统的不良反应。

Objective To study the prevention effect of urapidil with lidoeaine to the cardiovascular stress in the cervical plexus blockade patients. Methods Forty patients undergoing thyroideetomy were randomly divided into two groups of twenty each. All the paients were anesthetized in the C 4 block. Group A with 1.25% lidocaine 30 ml, and the group B were used with l. 25% lidocaine and urapidil 0. 4-0. 5 mg/kg combined30 ml. Oxygen was inhaled routinely through nasal tube during operation. Fentanyl 0. 1 nag and droperidol 5 mg were injected in the vein incision. The electrocardiogram, SpO2, blood pressure were monitored continually. The noradenaline（NE） and adrenalin（E） plasma concentration were also measured. Results There were no sig- nificant differences in group A and group B （ P 〉 0. 05 ） , the changes of MAP after5 minutes and10 minutes blockade in group A are significantly different than that in group B （ P 〈0.01 ）. The MAP after block was more lower than that before block. The serum NE and E level between pre-block and post block in group A were more different than that in group B （ P 〈 0. 05 ）. Conclusion Urapidil and lidocaine can effectively depress sympathetic responses to cervical plexus block.