不同剂量艾司洛尔预防围拔管期心血管反应临床观察

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1、不同剂楚艾司洛尔预防用拔管期心血管反应临床观察【关键词】剂量【摘要】目的观察不同剂量艾司洛尔对气管拔管时心血管反应的预防作用。方法将80例择期手术患者随机分为A、B、C、D组，A组为对照组，B组为1.0mg/kg组,C组为1.5mg/kg组,D组为2.0mg/kg,拔管前分别注射生理盐水5ml、艾司洛尔l.Omg/kg.1.5mg/kg>2.0mg/kg,2min后拔管。并记录病人术前、拔管时、拔管后1、5、lOmin时收缩压(SBP)、舒张压(DBP)、心率(HR),并算出相应的脉率和收缩压的乘积(R

2、PP)。结果A组拔管时及拔管后1〜3minSBP、DBP、HR、RPP及拔管后5minDBP、HR、RPP显著高于术前(P<0.05),B、C、D三组拔管时SBP、DBP、HR、RPP显著低于A组(P<0.05),拔管后IminSBP、HR、RPP显著低于A组(P<0.01);拔管后3minB>C、D三组SBP,C、D组HR、RPP显著低于术前(P<0.05);拔管后5minC、D两组SBP、HR、RPP,B组RPP显著低于A组(P<0.05);C组拔管后3〜lOminHR,RPP,D组拔管时及拔管后1

3、〜lOminHR>RPP显著低于术前，但冇4例心动过缓;B组拔管时HR、RPP明显高于术前，其余各时间点SBP、DBP、HR、RPP与术前比无显著变化(P>0.05)。结论静注艾司洛尔1.5mg/kg对气管拔管时的心血管反应预防效果较好且副作用少。【关键词】艾司洛尔;拔管;心血管系统;麻醉ClinicalobservationoftheeffectsofdifferentdosesofesmololoncardiovascularresponsestotrachealextubationSHAOLan.

4、(GuangdongHospitalofChineseMedicine,Guangzhou,Guangdong512000,China)[Abstract]ObjectiveToobservetheeffectsofdifferentdosesofesmololoncardiovascularresponsestotrachealextubation.Methods80patientsundergoingelectivesurgeryweredividedinto4groups.Beforethetra

5、chealextubation,patientsreceived5mlsaline,esmolol1.Omg/kg,1.5mg/kg,2.Omg/kgrespectivelybeforethetrachealwasextubated2minlater.Thesystolicpressure(SBP),diastolicpressure(DBP)andheartrate(HR)wererecordedbeforeoperation,attrachealextubationandl，3,5，lOminaft

6、erthetrachealextubation.Rate-pressureproductwasderived.ResultsComparedwiththosebeforetheoperationtheSBP,DBP,HR,RPPofgroupApatientsincreasedsignificantlyatthetrachealextubationandlto3minaftertheextubation(P<0.05),andtheDBP,HR,RPPincreasedremarkably5minaft

7、ertheextubation(P<0.05).AndtheSBP,DBP,HR,RPPofthepatientsofthegroupB,CandDatthetrachealextubationareremarkablylowerthangroupA(P<0.05).1minuteaftertheex-tubationtheSBP,HRandRPPareremarkablylowerthangroupA(PvO.Ol);3minutesaftertheextubationtheSBPofthegroup

8、B,CandD,andtheHR,RPPofthegroupCandDareremarkablylowerthanbeforetheoperation(P<0.05);5minaftertheextubationtheSBP,HR,RPPofgroupCandD,theRPPofgnnipBarelowerthanAseries(P<0.05);ComparedwiththosebeforetheoperationtheHR,RPPofth