不同麻醉药物在鼻内镜手术中对血流动力学的影响

目的:研究在鼻内镜控制性降压手术中,不同麻醉药物对血流动力学的影响。方法:60例需要行鼻内镜手术的病人,随机分为A组犤芬太尼复合硝普纳(SNP)组犦和B组(瑞芬太尼复合SNP组),每组30例。A组先用微量泵注芬太尼;B组用微量泵注瑞芬太尼,当需要控制性降压时,两组均泵注SNP将平均动脉压(MAP)降至并维持于60～70mmHg。观察降压前、降压达目标时,维持降压5～60min及停降压5、10min时的血流动力学变化,同时观察麻醉苏醒及不良反应等情况。结果:降压期间两组的降压效果均满意,但A组HR明显增快,B组HR稳定。血压下降速度B组明显快于A组,而到达目标时SNP用药量较A组减少。B组血流动力学变化幅度,呼之睁眼和术后苏醒恢复状况均优于A组(P<0.05)。结论:瑞芬太尼复合SNP能强化SNP的降压效果,减少SNP用量,维持降压中血流动力学的稳定。麻醉深度易控制,术后苏醒快,安全性佳。

The effects of different anesthesia drugs on hypotension in nasal endoscopic surgery

Objective To study the effects of different anesthesia drugs on hypotension used for controlled hypotension in nasal endoscopic surgery. Methods Sixty patients undergoing nasal endoscopic surgery were randomly divided into A group (fentanyl and sodium nitroprusside group) and B group (remifentanil and sodium nitroprusside group). Anesthesia was maintained with the continuous infusion of either fentanyl in A group or remifentanil in B group. Controlled hypotension was performed and the MAP was reduced and ma...