不同剂量乌拉地尔预防垂体后叶素诱发腹腔镜子宫肌瘤剥除术患者心血管反应的效果

Efficacy of different doses of urapidii in preventing pituitrin-induced cardiovascular responses in patients undergoing laparoscopic myomectomy

目的评价不同剂量乌拉地尔预防垂体后叶素诱发腹腔镜子宫肌瘤剥除术患者心血管反应的效果。方法拟在全身麻醉下行腹腔镜子宫肌瘤剥除术患者60例，采用随机数字表法，将其随机分为4组（n=15），对照组（c组）静脉注射生理盐水5ml；不同剂量乌拉地尔组（U1-3组）分别静脉注射乌拉地尔0。3、0．5、0．8mg／kg。5min后子宫肌瘤部位注射垂体后叶素6U和生理盐水20ml混合液，随后剥除子宫肌瘤。术中维持BIS值45～55。记录垂体后叶素注射后心血管反应的发生情况。结果C组、U1组、U2组和U3组心血管反应发生率分别为100％、67％、40％和20％。与C组比较，U1组、U2组和U3组心血管反应发生率降低（P〈0．01）；与U，组比较，U2组和U，组心血管反应发生率降低（P〈0．01）；U2组和U3组心血管反应发生率比较差异无统计学意义（P〉0．05）。结论乌拉地尔可预防垂体后叶素诱发腹腔镜子宫肌瘤剥除术患者的心血管反应，其适宜剂量为0．5mg／kg。

Objective To evaluate the efficacy of different doses of urapidil in preventing pituitrin-induced cardiovascular responses in patients undergoing laparoscopic myomectomy. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 27-41 yr, weighing 55-65 kg, scheduled for elective laparoscopic myomectomy under general anesthesia, were randomly divided into 4 groups （n = 15 each）： control group （group C） and urapidil 0.3, 0.5 and 0.8 mg/kg groups （groups U1-3 ） . Urapidil 0.3, 0.5 and 0.8 mg/kg were injected intravenously in Ui.3 groups respectively, while normal saline 5 ml was given in group C. The mixture of pituitrin 6 U and normal saline 20 ml was injected into the site of hysteromyoma 5 rain later. The operation was then started. BIS value was maintained at 45- 55. The occurrence of cardiovascular responses was recorded. Results The incidences of cardiovascular responses were 100% , 67 %, 40% and 20% in groups C and U1-3 respectively. The incidence of cardiovascular responses was significantly lower in groups U1-3 than in group C, and in groups U2.3 than in group U1 （ P 〈 0.01 ）. There was no significant difference in the incidence of cordiovascular responses between U2 and U3 groups （ P 〉 0.05）. Conclusion Urapidil can prevent pituitrin-induced cardiovascular responses in patients undergoing laparoscopic myomectomy and the optimal dose is 0.5 mg/kg.