重度高血压伴心肌缺血行腹部急诊手术的麻醉处理

目的 探讨遍血压伴心肌缺血在全麻下行急诊腹部手术时应用佩尔地平、艾司洛尔及硝基甘油治疗的临床效果。方法 上述患者２４例，于诱导插管及前术毕拔管前，静注艾司洛尔、佩尔地平，分别观察静注后至３０ｍｉｎ、２０ｍｉｎ时收缩压（ＳＢＰ），舒张压（ＤＨＯＰ），心率（ＨＲ）的变化，术中观察静滴硝基甘油于６０ｍｉｎ及停药后至３０ｍｉｎ，ＳＢＰ，ＤＢＰ，ＨＲ的变化。结果 诱导插管隧静注药物后２ｍｉｎ，ＳＢＯＰ，ＤＢ

Anesthetic treatment for acute abdomen surgery complicated with severe hypertension and myocardial ischemia

AIM To determine the clinical curative effect of perdipine, esmolol and nitroglycerin used in severe hypertension and myocardial ischemia complicated by acute abdomen surgery under general anesthesia. METHODS Twentyfour patients were observed. Before induction and intubation of anesthesia and extubation, esmolol and perdipine were infused and then the changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) were observed from start to 20 or 30 minutes. During the operation, these changes were also observed from the start of venous dropping of nitroglycerin to 60 minutes and to 30 minutes after the stop of dropping nitroglycerin. RESULTS After infusion of esmolol and perdipine before induction and intubation of anesthesia, SBP, DBP and HR decreased from 2 to 20 minutes significantly, with SBP recovery in 25 minutes and HR recovery in 30 minutes. After infusion of those drugs before extubation, SBP, DBP and HR decreased significantly and were maintained for 20 minutes. During operation and continuously dropping nitroglycerin in veins, SBP and DBP decreased significantly from the start to 30 minutes, but HR didn't decrease. CONCLUSION Perdipine, esmolol and nitroglycerin can decrease hypertension and tachycardia significantly, maintain blood pressure and HR stability during induction and intubation of anesthesia and extubation, keep haemodynamics stable during operation and finally decrease the dosage of each drug and its side effects.