尼卡地平联合艾司洛尔控制性降压在腭裂修复术中的应用

Application of Nicardipine Combined with Esmolol for Controlled Hypotension during Palatoplasty

目的：探讨尼卡地平联合艾司洛尔控制性降压在腭裂修复术中应用的效果和可行性。方法：40例ASAⅠ~Ⅱ级、Ⅱ~Ⅲ度腭裂患儿随机分为控制性降压组和对照组,各组20例。观察两组麻醉诱导前（T0）、手术开始后15 min（T1）、手术结束时（T2）和睁眼拔管时（T3）的平均动脉压（MAP）和HR,手术时间,拔管时间及术野评分。结果：两组T0的MAP和HR比无统计学意义。T1和T2,控制性降压组的MAP和HR比对照组低（P〈0.05）。控制性降压组T3的MAP比对照组低（P〈0.05）,而HR比较无统计学意义。控制性降压组的手术时间比对照组短（P〈0.05）,术野评分较低（P〈0.05）;两组拔管时间无统计学意义。结论：尼卡地平联合艾司洛尔控制性降压用于腭裂修复术,安全有效,值得推广。

Objective：To study the effect and the feasibility of nicardipine combined with esmolol for controlled hypotension during palatoplasty.Methods：Forty ASA Ⅰ～Ⅱ patients with Ⅱ～Ⅲ degree of cleft palate were randomly divided into controlled hypotension group and control group,20 for each group.The mean arterial blood pressure（MAP）and heart rate（HR）between two groups were recorded respectively before anesthesia induction,15 minutes after the beginning of the operation,at the end of operation and when eyes opened for extubation.The duration of operation,the time for extubation,and the score of operative field were also recorded.Results：There were no significant difference in MAP and HR between two groups before anesthesia induction.MAP and HR in the controlled hypotension group were significantly lower at 15 minutes after the beginning of the operation and at the end of operation than those in the control group（P〈0.05）.For extutation,the MAP in the controlled hypotension group was significantly lower than that in the control group（P〈0.05）,but the HR had no statistical difference.The duration of operation in the controlled hypotension group was significantly shorter than that in the control group（P〈0.05）.The score of operative field was significantly lower in the controlled hypotension group（P〈0.05）.There was no statistical difference for time of extubation.Conclusion：Nicardipine combined with esmolol for controlled hypotension during palatoplasty is safe and effective,and should be promoted.