不同药物预防老年患者颈丛阻滞后心血管副反应的临床疗效观察

Observation on the Clinical Efficacy of Different Drugs for Preventing Cardiovascular Adverse Reactions in Elderly Patients After Cervical Plexus Block

[目的]比较乌拉地尔、尼卡地平预防颈丛阻滞后心血管副反应的临床效果和安全性.[方法]将60例择期行甲状腺瘤手术的年龄大于60岁的患者随机分为A,B,C三组,每组20例.在颈丛阻滞完成后立即给予药物静脉注射：A组乌拉地尔0.5 mg/kg,B组尼卡地平15 μg/kg,C组生理盐水2 mL.分别记录颈丛阻滞前、阻滞后即时,5,10,20,30 min的收缩压（SBP）,舒张压（DBP）,心率（HR）,观察麻醉效果.[结果]总有效率：A组95% ,B组90% ,C组95%,三组比较差异均无显著性（P〉0.05）.SBP：A、B两组给药后5 min、20 min、30 min与麻醉前比较,无显著性差异（P〉0.05）;DBP：A组麻醉后20 min、30 min 与麻醉前比较,无显著性差异（P〉0.05） ;B组麻醉后20 min较麻醉前比较,无显著性差异（P〉0.05）,C组麻醉后5 min、10 min、15 min、20 min SBP、DBP较麻醉前明显上升（P〈0.05）;在HR方面,阻滞后3组与麻醉前相比均增加,在A组给药后10 min下降至正常水平,而B、C两组持续到给药后20 min;颈丛阻滞后30 min,各组HR趋于稳定.[结论]使用乌拉地尔0.5 mg/kg和尼卡地平15 μg/kg均可有效的预防老年患者颈丛阻滞后心血管副作用,且乌拉地尔效果优于尼卡地平.

[Objective] To compare the clinical efficacy and safety of urapidil vs. nicardipine for preventing cardiovascular adverse reactions in elderly patients after cervical plexus block. [Methods] Sixty patients aged over 60 years old and scheduled for the surgery of thyroma were randomly divided into group A, group B and group C with 20 cases in each. All patients were given intravenous injection of the drugs after ceivical plexus block. Group A was injected with urapidil 0.5mg/kg, and group B was injected with nicardipine 15μg/kg, and group C received normal saline 2ml. The SBP, DBP and HR were recorded before the anesthesia, at the same t{me of anesthesia, at 5rain, 10rain, 20min and 30rain after anesthesia. The anesthetic effect was observed. [Results] The total effective rate of group A, group 13 and group C was 95%, 90% and 95%, respectively, and there was no significant differ ence among 3 groups（ P 〉0.05）. Compared with before anesthesia, there was no significant difference in SBP at 5rain, 20min and 30min between group A and group B（ P 〉0.05）. There was no significant difference in DBP in group A between 20min and 30min after anesthesia and before anesthesia（ P 〉0. 05）. There was no significant difference in DBP in group B 20min after anesthesia and before anesthesia（ P 〉0.05）. Compared with before anesthesia, the SBP and DBP at 5min, 10min, 15min and 20min after anesthesia in group C were significantly increased （ P 〈0.05）. Compared before anesthesia, the HR in 3 groups after anesthesia was increased, and that in group A returned to normal level at 10min after administration, but that in group B and group C returned to normal level at 20min after administration. At 30min after anesthesia, the HR in 3 groups became stable. [Conclusion] Urapidil 0.5mg/kg and nicardipine 15μg/kg can effectively prevent cardiovascular adverse reactions in elderly patients after cervical plexus block, and the effect of urapidil is better than nicardipine.