Wu Tao, Yang Jun, Luo Kai, Wang Yingwei, You Xinmin
Department of Anesthesia, Xinhua Hospital of Jiaotong University Medical School, Shanghai, 200092, China.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2006 Dec;20(24):1126-9.
To assess the clinic efficacy of compound induced hypotension during functional endoscopic sinus surgery.
Sixty patients with chronic sinusitis and nasal polyps were divided into three groups: Sodium nitroprusside (SNP) group (A), diltiazem+SNP group (B), labetalol+SNP group (C). We started induced hypotension with beginning of functional endoscopic sinus surgery. Mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI) and ejection fraction (EF) were recorded during induced hypotension. Sugar and lactic acid in arterial and venous blood were also assayed. Then we calculate rate-pressure product (RPP), arteriovenous difference in blood glucose [D(v-a) BG], blood glucose extraction rate (BGER), arteriovenous difference in lactate [L(v-a)] and lactate produce rate (LPR).
The dose of SNP applied in group B and C are fewer than group A ( P <0. 05). The cardiovascular functions and body metabolism of the patients in group B and C were stable and the anesthetic effect was satisfactory. Few adverse reaction of the drug was found in present study.
Induced hypotension with SNP compound of diltiazem or labetalol is an ideal way in clinical use and produce satisfied synergistic effect.
评估功能性鼻内镜鼻窦手术中复合诱导低血压的临床疗效。
将60例慢性鼻窦炎伴鼻息肉患者分为三组：硝普钠（SNP）组（A组）、地尔硫䓬+SNP组（B组）、拉贝洛尔+SNP组（C组）。在功能性鼻内镜鼻窦手术开始时启动诱导低血压。在诱导低血压期间记录平均动脉压（MAP）、心率（HR）、心输出量（CO）、心脏指数（CI）和射血分数（EF）。同时检测动脉血和静脉血中的血糖及乳酸。然后计算率压乘积（RPP）、动静脉血糖差值[D（v-a）BG]、血糖摄取率（BGER）、动静脉乳酸差值[L（v-a）]和乳酸生成率（LPR）。
B组和C组应用的SNP剂量少于A组（P<0.05）。B组和C组患者的心血管功能和机体代谢稳定，麻醉效果满意。本研究中未发现药物不良反应。
地尔硫䓬或拉贝洛尔与SNP复合诱导低血压在临床应用中是一种理想的方法，可产生满意的协同效果。
