尼卡地平复合艾司洛尔持续静脉泵注对LEAOD患者行血管旁路移植术循环功能的影响

目的 观察尼卡地平复合艾司洛尔持续静脉泵注对下肢动脉硬化闭塞症(LEAOD)患者行人工血管旁路移植术循环功能的影响.方法 选择LEAOD行人工血管旁路移植术患者76例.随机分为两组:尼卡地平复合艾司洛尔持续静脉泵注组(A组)及对照组(B组).每组各38例.观察并记录麻醉前10 min(T0)、麻醉后10 min(T1)、麻醉后1 h(T2)、及手术结束时(T5)之MAP、HR、SpO2的变化.计算HR与SBP的乘积(RPP)、手术时间、术毕麻醉苏醒时间和术中芬太尼的用药量.结果 B组于T1至T3时HR和RPP值及T2至T3时MAP值显著高于T0时(P<0.05或0.01);A组于T1至T3时MAP、HR及RPP值显著低于T0时及B组(P(0.05或0.01).术毕麻醉苏醒时间A组短于B组(P<0.05),芬太尼用药量A组低于B组(P<0.05).结论 尼卡地平复合艾司洛尔持续静脉泵注可安全有效地降低心肌氧耗,维持LEAOD患者行人工血管旁路移植术循环功能相对稳定.

Affects of Continuous intravenous infusion of Nicardipine combined with esmolol on circulatory function for patients with LEAOD in vascular bypass surgery

Objective To observe the effect of continuous intravenous infusion of nicardipine combined with esmolol on circulatory function for patients with lower extremity arterial occlusive disease（LEAOD） in artificial blood vessel bypass surgery.Methods 76 cases of LEAOD with vascular bypass grafting were randomly divided into two groups：continuous intravenous infusion of Nicardipine combined with esmolol（group A） and control group（group B）,38 patients in each group.Before anesthesia 10 min（T0）、after anesthesia 10 min（T1） 、1 h（T2） and the end of surgery（T3） of MAP、HR、SpO2 were observed and recorded.The product of HR and SBP（RPP）、operative time、anesthesia time of surgery and intraoperative fentanyl dosage were calculated.Results At the time point of T1 to T3 HR and RPP values and at the time point of T2 to T3 MAP was significantly higher than T0 in group B（P0.05 or 0.01）;and in group A at the time point of T1 to T3 MAP,HR and RPP were significantly lower than T0 and in group B（P0.05 or 0.01）.Awakening time in group A was shorter in group B（P0.05）,and fentanyl dosage in group A significantly lower than in group B（P0.05）.Conclusions Continuous intravenous infusion of nicardipine combined with esmolol can safely and effectively reduce myocardial oxygen consumption,and maintain circulatory function for LEAOD patients is relatively stable with artificial blood vessel bypass surgery.