颅脑手术中应用硝酸甘油或复合艾司洛尔调控血压效果的比较

目的：比较艾司洛尔复合硝酸甘油（NTG）降压与单纯硝酸甘油降压效果。方法：36例美国麻醉医师协会（ASA）I-Ⅱ级颅外择期手术病人分为两组：艾司洛尔复合NTG组18例、单纯NTG组18例，观察并比较两组控制性降压时血气、血流动力学的变化。结果：艾司洛尔能明显加快NTG起效速率，NTG用量减少55.7%，并能抑制单纯NTG控制性降压时反射性心率（HR）增快；停止降压后血压平稳上升，收缩压乘积（RPP）值下降；动脉血氧饱和度（SaO2)、剩余碱（GE）仅轻度下降。与单纯NTG组比较有显著差异（P＜0.01)。结论：艾司洛尔复合NTG控制性降压有明显的协同作用，无反跳现象，对动脉血气影响小。

Comparison of Effects of Controlled Hypotension between NTG and Esmolol plus NTG in Operations on Cranium

To compare the effects of controlled hypotension between nitroglycerin (NTG) and esmolol plus NTG in operations on cranium. Methods:Thirty-six patients of ASA I-II were randomly assigned into 2 groups. Group I (n = 18) was treated with intravenous esmolol plus NTG infusion, while group II ( n = 18) was treated only with intravenous NTG infusion. Results: Compared with group 11, the used dosage of NTG decreased by 55.7% ,the reflex heart rate augmentation was suppressed,the blood pressure after discontinuance of drugs increased steadily,rate-pressure product value decreased and he-modynamics was stable in group I. The changes of PaO2 and BE in group I were significantly lower than those in group II (P<0.01).Conclusion:Using esmolol plus NTG infusion may produce synergism and slighter influence on arterial blood gas,and no rebounding phenomenon occurs.