雷米芬太尼与硝酸甘油用于鼻内镜手术控制性降压的对比研究

目的：对比评价鼻内镜手术中应用雷米芬太尼和硝酸甘油（NTG）行控制性降压的效果。方法：60例择期行鼻内镜手术患者,随机分为雷米芬太尼组（R组）和NTG组（N组）。R组以雷米芬太尼0.1~0.5μg/（kg.min）维持降压,N组以NTG 0.5~3μg/（kg.min）维持降压,均将平均压（MAP）降至60~65 mm Hg,持续60 min,观察两组患者MAP、心率（HR）变化、失血量及清醒拔管时间。结果：降压实施后两组MAP均达预定目标,组间比较差异无显著性（P〉0.05）。R组HR显著低于降压前（P〈0.05）,而N组显著高于降压前（P〈0.05）,组间比较差异非常显著（P〈0.05）。两组失血量及清醒拔管时间差异无显著性。结论：鼻内镜手术中应用雷米芬太尼行控制性降压安全、有效,具有对心功能影响小的优点。

Comparative Study between Remifentanil and Nitroglycerin for Deliberate Hypotension in Patients during Endoscopic Sinus Surgery

Objective：To compare the effects of remifentanil and nitroglycerin for deliberate hypotension in patients during endoscopic sinus surgery. Methods..60 patients undergoing endoscopic sinus surgery were randomly devided into group R and group N. Patients in group R were infused with remifentanil 0.1-0.5 μg/（kg·min） and patients in group N were infused with nitroglycerin 0.5-3 μg/（kg · rain）. The target of deliberate hypotension was fixed at MAP 60-65 mm Hg, which was maintained for 60 minutes. The hemodynamic changes in two groups were recorded and amount of blood loss,extubation time were also compared. Results：The patients in both groups could maintain MAP at the target of deliberate hypotension,There was no significant difference between two groups （P〉0.05）. HR was signifi- cant reduced in R group compared with that before（P〈0.05） and was significant increased in N group（P〈0.05）. The amount of blood loss and extubation time were no any significant difference between two groups. Conclusion ：Deliberate hypotension with remifentanil is effective and safe with less influence on cardiac function in patients undergoing endoscopic sinus surgery.