Steib A, Freys G, Curzola U, Ravanello J, Piat J M
Service d'Anesthésie-Réanimation Chirurgicale, Hôpital de Hautepierre, Strasbourg.
Ann Fr Anesth Reanim. 1991;10(2):113-6. doi: 10.1016/s0750-7658(05)80451-4.
The effects of urapidil on the haemodynamic response to endotracheal intubation were compared to that of placebo in two groups of 25 patients scheduled for general surgery. Normal saline solution or 0.4 mg.kg-1 urapidil were injected 3 min before induction of anaesthesia with 3 micrograms.kg-1 fentanyl, 0.3 mg.kg-1 etomidate and 0.1 mg.kg-1 vecuronium. Blood pressure (Pasys, Padia, Pa) and heart rate were measured continuously by servoplethysmomanometry before giving the test drug (T0), at the time when the lowest blood pressure was recorded during the three minute period between giving the drug and induction (T1), at the time when the lowest blood pressure was recorded during the three minute period between induction and endotracheal intubation (T2), at the time when the highest blood pressure was recorded immediately after intubation (T3), three minutes after intubation (T4), five minutes after intubation (T5), and at the time when the lowest blood pressure was recorded after surgery had been started (T6). It was planned to give a 25 mg urapidil dose to any patient, from either group, who had a Pasys greater than 200 mmHg for more than 60 sec. Giving urapidil lowered Pasys (T1) by 16%, whilst heart rate increased by 12%. The blood pressure peak due to endotracheal intubation was lower in those patients who had been given urapidil than in the placebo group (T3; p less than 0.05). Six patients in the latter group required the 25 mg urapidil dose, versus 2 in the urapidil group. The preventive effects of urapidil seem to be similar to those obtained with other antihypertensive agents.(ABSTRACT TRUNCATED AT 250 WORDS)
在两组计划进行普通外科手术的25例患者中,比较了乌拉地尔与安慰剂对气管插管血流动力学反应的影响。在使用3μg/kg芬太尼、0.3mg/kg依托咪酯和0.1mg/kg维库溴铵诱导麻醉前3分钟,注射生理盐水或0.4mg/kg乌拉地尔。在给予试验药物前(T0)、给药与诱导之间3分钟内记录到最低血压时(T1)、诱导与气管插管之间3分钟内记录到最低血压时(T2)、插管后立即记录到最高血压时(T3)、插管后3分钟(T4)、插管后5分钟(T5)以及手术开始后记录到最低血压时(T6),通过伺服体积描记法连续测量血压(收缩压、舒张压、平均动脉压)和心率。计划对两组中任何收缩压大于200mmHg超过60秒的患者给予25mg乌拉地尔剂量。给予乌拉地尔使收缩压(T1)降低16%,同时心率增加12%。接受乌拉地尔治疗的患者气管插管引起的血压峰值低于安慰剂组(T3;p<0.05)。后一组中有6例患者需要给予25mg乌拉地尔剂量,而乌拉地尔组为2例。乌拉地尔的预防作用似乎与其他抗高血压药物相似。(摘要截断于250字)