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目的:观察乌拉地尔在正颌手术控制性降压中的应用效果。方法:选取正颌手术患者40例,ASAⅠ～Ⅱ级。随机分为2组,U组(乌拉地尔复合异丙酚组20例)和P组(异丙酚组20例)。麻醉诱导,2组都给予咪达唑仑0.05mg/kg、芬太尼2μg/kg、异丙酚2mg/kg、罗库溴铵0.8mg/kg行麻醉诱导插管。2组均由2%七氟烷和异丙酚维持麻醉。U组在异丙酚的基础上复合乌拉地尔行控制性降压。P组仅用异丙酚行控制性降压。2组都以平均动脉压(MAP)维持在60～65mmHg为目标。记录2组在诱导前后及降压前后各个时间段的心率(HR)、收缩压(SBP)、舒张压(DBP)及MAP的值,并进行比较,同时根据Fromme术野评分表评定手术视野质量。采用SPSS11.0软件包进行统计学分析。结果:控制性降压期间,2组MAP都低于术前(P<0.01)。U组在5、10、20min的MAP显著低于P组(P<0.01)。U组的术野评分也优于P组(P<0.01)。但两组心率都有增高,差异不显著(P>0.01)。结论:乌拉地尔用于正颌手术控制性降压安全有效,起效迅速,可使术野质量更加清晰。
Objective: To observe the effect of urapidil in controlled hypotension of orthognathic surgery. Methods: Forty patients with ASA Ⅰ ~ Ⅱ were selected for orthognathic surgery. Randomly divided into two groups, U group (Urapidil propofol group 20 cases) and P group (Propofol group 20 cases). Induction of anesthesia, both groups were given midazolam 0.05mg / kg, fentanyl 2μg / kg, propofol 2mg / kg, rocuronium 0.8mg / kg anesthesia induced intubation. Both groups were anesthetized with 2% sevoflurane and propofol. U group in the propofol complex based on the control of Urapidil blood pressure. P group only propofol line control blood pressure. Both groups aimed at maintaining mean arterial pressure (MAP) at 60-65 mmHg. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and MAP of the two groups were recorded and compared before and after induction and before and after antihypertensive treatment. At the same time, the visual field quality . SPSS11.0 software package for statistical analysis. Results: During controlled hypotension, MAP was lower in both groups than before surgery (P <0.01). The MAP in group U at 5, 10 and 20 min was significantly lower than that in group P (P <0.01). The operative field score in group U was also better than that in group P (P <0.01). However, both groups had higher heart rate, with no significant difference (P> 0.01). Conclusion: Urapidil is a safe and effective controllable antihypertensive for orthognathic surgery with rapid onset of action, which can make surgical field quality more clear.