艾司洛尔和乌拉地尔预防气管插管及拔管所致心血管反应的效果比较

Comparison the Cardiovascular Effects of Esmolol and Uradil During Intubation and Extubation.

目的:观察全麻病人插管及拔管期间静注艾司洛尔或乌拉地尔对心血管反应及心率变异性的影响。方法:60例病人随机分为3组,每组20例,Ⅰ组为对照组,Ⅱ组为艾司洛尔组,Ⅲ组为乌拉地尔组。观察插管及拔管期间1、3、4、5、6、10分钟3组SP、DP、HR、BIS、HRV变化。结果:Ⅰ组SP和DP于插管后1分钟显著升高(P<0.05),Ⅱ组SP在插管后显著升高,HR在插管后显著下降(P<0.05),Ⅲ组SP于插管后显著下降(P<0.05),DP于插管后1分钟显著下降(P<0.05);Ⅰ组SP、DP、HR拔管后1分钟显著升高(P<0.05),Ⅱ组HR拔管后10分钟均显著下降(P<0.05),SP拔管后3-9分钟则低于基础值(P<0.05),Ⅲ组HR拔管后5分钟显著升高(P<0.05),SP、DP拔管后3分钟显著下降(P<0.05)。结论:艾司洛尔和乌拉地尔均可有效降低应激引起的心血管反应。乌拉地尔用于单纯血压升高的病人有利,而艾司洛尔对于心率增快的病人更为有利。

Purpose: Comparison the cardiovascular effects of esmolol and uradil (luring intubation and extubation. Methods:60 operation cases were equally allocated into three groups, group I ( control group) , Ⅱ (esmolol group) and group Ⅲ ( uradil group). Cardiovascular pa-rameters were monitored during intubation and extubation. Results: In group I there were significant increases of blood pressure and heart rate during intubation and extubation. In group Ⅱ and group Ⅲ the increases of blood pressure induced by intubation and extubation were in-hibited and in group II the increases of rate were also inhibited. Conclusion: Both esmolol and uradil could depress the stress response in-duced by intubation and extubation. For tachycardia patients esmolol might be the best choice.