颅脑手术中应用硝酸甘油或复合艾司洛尔调控血压效果的比较

Comparison of Effects of Controlled Hypotension between NTG and Esmolol plus NTG in Operations on Cranium

目的:比较艾司洛尔复合硝酸甘油(NTG)降压与单纯硝酸甘油降压效果。方法:36例美国麻醉医师协会(ASA)Ⅰ～Ⅱ级颅外择期手术病人分为两组:艾司洛尔复合NTG组18例、单纯NTG组18例,观察并比较两组控制性降压时血气、血流动力学的变化。结果:艾司洛尔能明显加快NTG起效速率,NTG用量减少55.7％,并能抑制单纯NTG控制性降压时反射性心率(HR)增快;停止降压后血压平稳上升,收缩压乘积(RPP)值下降;动脉血氧饱和度(SaO_2)、剩余碱(BE)仅轻度下降。与单纯NTG组比较有显著差异(P<0.01)。结论:艾司洛尔复合NTG控制性降压有明显的协同作用,无反跳现象,对动脉血气影响小。

To compare the effects of controlled hypotension between nitroglycerin (NTG) and esmolol plus NTG in operations on cranium. Methods:Thirty-six patients of ASA I-II were randomly assigned into 2 groups. Group I (n = 18) was treated with intravenous esmolol plus NTG infusion, while group II ( n = 18) was treated only with intravenous NTG infusion. Results: Compared with group 11, the used dosage of NTG decreased by 55.7% ,the reflex heart rate augmentation was suppressed,the blood pressure after discontinuance of drugs increased steadily,rate-pressure product value decreased and he-modynamics was stable in group I. The changes of PaO2 and BE in group I were significantly lower than those in group II (P<0.01).Conclusion:Using esmolol plus NTG infusion may produce synergism and slighter influence on arterial blood gas,and no rebounding phenomenon occurs.