联合应用利多卡因和酚妥拉明对高血压病人气管导管拔除时心血管反应的影响

Influence of the Injection of Lidocaine and Phentolamine on the Cardiovascular Responses at the Moment of Tracheal Extubation After General Anesthesia

目的:观察联合应用利多卡因和酚妥拉明对高血压病人麻醉苏醒期拔气管导管时对心血管不良反应的影响。方法:全麻气管插管的高血压病人60例,ASAⅡ级,随机分为3组,每组20例,A组不用任何药物,B组拔管前2min静注利多卡因1.0mg·kg-1,C组拔管前2min静注利多卡因1.0mg·kg-1和酚妥拉明2mg,分别记录术毕时各项基础值,拔管前,拔管后瞬间,拔管后5min和10min时的平均动脉压（MAP）和心率（HR）,并按收缩压和心率计算平均收缩乘积（RPP）。同时观察各组并发症的情况。结果:A组病人拔管前,后与基础值相比均显著增加,且并发症较多;B组病人拔管前,后瞬间MAP,HR和RPP均增加,并持续数分钟,C组病人拔管前,后与基础值相比无显著差异。B,C两组均无明显的并发症。结论:高血压病人拔气管导管前联合静注利多卡因和酚妥拉明能有效地预防拔管引起的心血管不良反应。

Objective: To study the cardiovascular effects of the combinating injection of lidocaine and phentolamine at the time of tracheal extubation after general anesthesia. Methods: 60 patients with hypertension who underwent general anesthesia were divided into three groups randomly, each group comprising 20 patients. No drug was used in Group A lidocaine 1.0mg· kg-1 was injected intravenousty two minutes before tracheal extubation in Group B; lidocaine l.0mg·kg-1and phentolamine 2mg was injected intra venocesly two minutes before tracheal extubation in Group C. The base vital signs and the mean arterial pressure , HR and RPP at the time just before and after tracheal extubation, the 5th and 10th minute after tracheal extubation and the complications were recorded. Results: Each parameters in Group A increased than the base vital signs, and there were several complications ; in group B only just before and after tracheal extubation each parameters increased; in group C there was no difference among them. In both group B and group C there was no complication. Conclusions: The combinating use of lidocaine and phentolamine is a good way for patients with hypertension at the time of tracheal extubation.