关键词: 拔管反应;乌拉地尔;艾司洛尔;脑外科学

    摘 要:目的 观察小剂量乌拉地尔和艾司洛尔联合应用对颅脑手术后气管拔管的心血管反应的影响. 方法 37例行开颅手术患者随机分为4组:A组(n=10，乌拉地尔0.4mg·kg-1 );B组(n=8，艾司洛尔0.5mg·kg-1 );C组(n=9，乌拉地尔0.2mg·kg-1 +艾司洛尔0.25mg·kg-1 );D组(n=10，生理盐水2mL).分别于拔管前2min静注.记录术前、给药前、给药后、拔管即刻、拔管后1，3和5min，回NICU后的SBP，DBP，MAP及HR. 结果 D组:血压、心率在拔管即刻均较术前升高(P<0.05).A组:拔管后1，3和5min的血压均低于术前(P<0.05)，心率在拔管即刻及拔管后明显较术前增快(P<0.05).C组:拔管后SBP明显低于给药前，DBP，MAP及HR无明显变化.拔管即刻:A组HR明显高于B组和C组(P<0.05)，A组和D组的HR无差异(P>0.05)，B组拔管即刻DBP和MAP高于A组(P<0.05)，C组拔管即刻SBP低于B组和A组(P<0.05).在NICU:B组心率高于A组(P<0.05). 结论 小剂量乌拉地尔与艾司洛尔联合应用可预防围拔管期血压升高，并能弥补拔管时单独应用乌拉地尔不能有效控制心率的不足，预防颅脑手术全麻后气管拔管时心血管反应.

    Effect of urapidil combined with a small┐dose es┐molol on the cardiovascular responses associated with tracheal extubation following surgery

    LI Yang，XIONG Li-Ze，CHEN Shao-Yang，WANG Qing-De，LEI Ting，YANG Kung，XIANG Ning

    Department of Anesthesiology，Xijing Hospital，Fourth Military Medical University，Xi'an710033，China

    Keywords:extubation;urapidil;esmolol;brain surgery

    Abstract:AIM To observe the effect of urapidil combined with a small-dose esmolol on cardiovascular responses to tra-cheal extubation following intracranial surgery.METHODS 37patients undergoing intracranial surgery were included in a randomized study consisting of4groups:Group D receiv-ing normal saline as the control ......