乌拉地尔预防高血压病人气管插管时心血管反应的观察

目的 观察乌拉地尔（URA）预防高血压病人全麻气管插管期间心血管反应的效果。方法 40例确诊高血压病择期全麻手术病人，术前血压控制在21．3／13．3kPa以下。随机分成A组（URA组，n=20)和B组（对照组，n=20.A组于麻醉诱导前5分钟静注URA0．5mg/kg,B组静注生理盐水。两组均以芬太尼、安定、维库溴铵和丙泊酚静脉诱导后气管插管。记录诱导前、静注URA后5分钟、诱导后及插管后1分钟、3分钟、5分钟SBp、DBp、MAPey HR,并计算RRP。结果A组静注URA后5分钟SBp、DBp、及MAP显著下降（P＜0．01），诱导插管期间SBp、DBp、MAP及RPP无明显变化，插管后1分钟HR显著加快（P＜0．05）。B组诱导后SBp、DBp及MAP显著下降（P＜0．01）；插管后1分钟、3分钟SBp、DBp、MAP及HR显著高于诱导前（P＜0．05，P＜0．01），插管后1分钟、3分钟及5分钟RPP均显著升高（P＜0．01），与A组同期比较差异有极显著意义（P＜0．01）。结论 应用URA能有效预防高血压病人气管插管时的心血管反应。

Effects of urapidil on cardiovascular responses to endotracheal intubation in patients with hypertension Ding

Objective To observe the effects of urapidil on cardiovascular responses to endotracheal intubation in patients with hypertension. Methods 40 cases whose blood pressures were controlled below 21.3/13.3kpa before operation were randomly divided into group A (urapidil group, n =20) and group B ( control group, n =20 ). Group A was injected I. V. Urapidil 0.5mg/kg and normal saline were injected I. V. in group B before endotracheal intubation. Anesthesia was induced with fentany1, valium, norcurium and propofol. SBp, DBp, MAP, HR and RPP were recorded before induction, 5 min after urapidil administration, during intubation and 1, 3, 5 min after intubation respectively. Results SBp, DBp and MAP in group A 5 min after urapidil administration were significantly decreased ( P <0.01), no significant changes occurred in SBp, DBp, MAP and RPP during intubation and 1, 3, 5, min after intubation. The HR was increased significantly than basic level before induction ( P <0.05). SBp, DBp and MAP after induction in group B were decreased significantly ( P <0.01). SBp, DBp, MAP and HR in 1 and 3 min after intubation were increased significantly ( P <0.05, P <0.01). RPP in 1, 3, 5 min after intubation were higher significantly than baseline, and were significantly higher than A group ( P <0.01). Conclusion The urapidil can prevent of effectively the cardiovascular responses on the endotracheal intubation.