瑞芬太尼和硝普钠对兔鼻黏膜血流的影响

目的 观察静脉持续泵入瑞芬太尼和硝普钠对兔鼻黏膜血流的影响。方法 将20只新西兰大白兔随机分为瑞芬太尼组（R组）和硝普钠组（S组），每组10只。建立兔全麻模型后，R组静脉持续泵入瑞芬太尼，S组静脉持续泵入硝普钠，分别记录2组给药前及给药后新西兰大白兔的心率（HR）、平均动脉压（MAP）、颈总动脉血流（CABF）和鼻黏膜血流（NBF）。结果 与给药前比较，R组HR减慢，MAP轻度下降，CABF轻度减少，NBF明显减少，且差异均有统计学意义（P<0.05）； S组HR增快，MAP显著下降，CABF轻度减少，NBF明显增加，差异亦均有统计学意义（P<0.05）。给药后，S组比R组MAP下降幅度大（P<0.05）； S组NBF明显增多，而R组NBF明显减少。S组同步监测的MAP与NBF呈负相关（r=-0.51， P＜0.05）, R组MAP与NBF间无明显相关性(P＞0.05)，2组MAP与CABF之间及CABF与NBF之间均无明显相关性(P＞0.05)。结论 与硝普钠相比，瑞芬太尼可显著减少鼻黏膜微循环血流，而对MAP和CABF影响轻微，提示选择瑞芬太尼用于鼻内镜手术的控制性降压更安全、有效。

Effects of sodium nitroprusside or remifentanil used in rabbits on nasal mucosal blood flow

ObjectiveTo evaluate the effect of continuous infusion of sodium nitroprusside (SNP) or remifentanil on nasal mucosal blood flow in rabbits. MethodsTwenty New Zealand white rabbits were randomly divided into the S group SNP infusion (n=10) and the R group remifentanil infusion (n=10). After the anesthesia model of rabbit was established, SNP was infused in the S group and remifentanil was infused in R group. Heart rate (HR), mean arterial pressure (MAP), common carotid artery blood flow (CABF) and nasal mucosal blood flow (NBF) were measured during each period before and during infusion of SNP or remifentanil. ResultsIn the R group, MAP, HR and CABF showed a mild decrease during infusion remifentanil, and NBF showed a significant decrease in the R group（P<0.05）. In the S group, MAP and CABF showed a significant decrease during infusion SNP（P<0.05）, whereas, HR and NBF showed a significant increase in the S group（P<0.05）. The decreases in MAP measured as percent change were greater in the S group than in the R group. But the increases in NBF measured as percent change were greater in the S group than in the R group（P<0.05）. A significant negative correlation was observed between MAP and NBF in the S group（P<0.05）, however, little correlation was observed between MAP and NBF in the R group. In both groups, the correlation between MAP and NBF was not significant（P>0.05）. ConclusionInfusion of remifentanil reduces NBF, without a major decrease in MAP and CABF and may be safer and more effective in endoscopic sinus surgery.