地尔硫卓在颈丛阻滞麻醉中的血流动力学稳定作用

目的研究地尔硫卓对颈丛阻滞麻醉引起的血流动力学变化的影响。方法 60例择期行甲状腺手术的女性患者随机平均分为地尔硫卓组(Dil组)和对照组(C组)。行一针法双侧颈浅丛和单侧颈深丛神经阻滞后10min后对血压升高增加、心率增快显著的患者,Dil组采用静脉注射地尔硫卓0·1mg/kg,继用输注泵以5μg/(kg·min)持续静脉输注;C组采用静脉注射硝酸甘油100μg,继用输注泵以0·5μg/(kg·min)持续静脉输注。记录麻醉前(T0)、颈丛阻滞后10min(T1)、20min(T2)、30min(T3)的SBP、DBP、HR,计算SBP与HR的乘积(RPP)。结果 C组在T1~T3时及Dil组在T1时的SBP、DBP和RPP均明显高于T0时,HR快于T0时,差异有统计学意义(P<0·05),C组在T2~T3时的SBP、DBP、RPP较T1时下降,HR较T1时增快,但差异无统计学意义(P>0·05);Dil组在在T2~T3时的SBP、DBP、RPP和HR与T1时相比较明显降低或减慢,差异有统计学意义(P<0·05),与T0时比较无统计学差异(P>0·05);在T2~T3时Dil组SBP、DBP、RPP和HR均较C组降低或减慢,差异有统计学意义(P<0·05)。结论地尔硫卓在颈丛阻滞麻醉过程中具有血流动力学稳定作用,可以缓解颈丛麻醉带来的血压升高、心率增快等副反应。

Stabilization of Diltiazem on hemodynamics in patients undergoing cervtal plexum block

Objective To investigate the effect of Diltiazem on hemodynamics in patients undergoing cervial plexum block.Methods 60 ASAI-II female patients undergoing selective thyroid surgery were randormly divided into Diltiazem group（group Dil） and control group（group C）.All patients were performed ＂One-needle-way＂bilateral superficial cervical plexus block and unilateral deep cervical plexus block.After10 minutes,these patients whose heart rate and blood pressure increased were intravenous injected with Diltiazem（0·1 mg/kg） following continuing injecting with 0·5μg/（kg·min） by infusion pumps in group Dil,or with Nitroglycerine（100μg） following continuing injecting with 0·5μg/（kg·min） by infusion pumps in group C.Record SBP,DBP,HR and RPP（product of multiplication by SBP and HR） before anesthesia（T0）,at10 min（T1）,20 min（T2） and30 min（T3） afterfinished cervical plexus block.Results In group C atT1~T3and in group Dil at T1SBP,DBP,RPPand HR was exceed or quicker than thatatT0（P0·05）;In group C atT2~ T3SBP,DBP and RPPwas lower and HR was quicker than thatatT1,butthere wasn＇tstatistical difference（P 0·05）.In group Dil SBP,DBP,RPP and HR at T1only was exceed or quicker than that at T0（P0·05）,but that at T2~T3was lower or slower than that at T1（P0·05） and that in group C（P0·05）.Conclusion Diltiazem has stabilization on hemodynamics in patients undergoing cervial plexum block.