乌拉地尔对气管内插管围拔管期心血管反应的影响

Effects of Urapidil on Cardiovascular Responses during Tracheal Extubation

目的 :观察乌拉地尔对气管内插管围拔管期心血管反应的影响。方法 :30例择期外科手术病人。 ASA ～ 级 ,除外高血压 ,心脑血管疾患。随机分为 A组、B组。术中全部采用气管内插管静吸复合麻醉。手术结束时 :A组 ( n =1 5 )给乌拉地尔 0 .1 5 mg/kg静脉注射 ,清醒后拔管指征明确 ,吸痰后充分吸氧 ,行气管拔管。 B组 ( n =1 5 )手术结束时 ,清醒后拔管指征明确 ,吸痰后充分吸氧 ,行气管拔管。结果 :两组术毕 SBP基础值相似。 A组吸痰拔管后 BP、HR、RPP呈平稳趋势。SBP>2 0 k Pa仅 1例 ,DBP、HR变化不大。B组吸痰后拔管 BP、HR、RPP较术毕升高 ,SBP>2 0 k Pa9例 ,DBP>1 3k Pa4例 ,HR>1 0 0次 /min4例 ,两组间差异显著 ( P<0 .0 5 ) ,两组无 1例发生低血压。结论

Objective: To observe the effect of urapidil on cardiovascular responses during tracheal extubation. Methods: 30 ASA I^II patients undergoing date-elective surgery were randomly divided into 2 groups, A and B.None of the patients had high blood pressure or cardiovascular disease,and all of them received tracheal intubation with intravenous inhalation combining analgesia. At the end of operations, group A (n=15) was provided with urapidil, 0.15mg/kg, intravenously, while group B (n=15) with nothing. Then with definite extubation indication,patients having waken up, and sufficient inhalation of oxygen after eliciting phlegm, tracheal extubation was applied. Results: Basic amount of SBP in both 2 groups were similar at the end of operations. After extubation with eliciting phlegm, BP,HR,RPP of group A remained stable, only in one case SBP>20kPa without evident change in HR or DBP. And BP,HR,RPP of group B rose ,compared with that at the end of operations.SBP>20kPa was found in 9 cases, DBP>13kPa in 4 ones,and HR>100b/min in 4 cases.Thus salient difference (P>0.05) existed between group A and B. Moreover, no low blood pressure happened. Conclusions: Urapidil may effectively attenuate the cardiovascular responses during tracheal extubation.