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目的:观察全麻病人插管及拔管期间静注艾司洛尔或乌拉地尔对心血管反应及心率变异性的影响。方法:60例病人随机分为3组,每组20例,Ⅰ组为对照组,Ⅱ组为艾司洛尔组,Ⅲ组为乌拉地尔组。观察插管及拔管期间1、3、4、5、6、10分钟3组SP、DP、HR、BIS、HRV变化。结果:Ⅰ组SP和DP于插管后1分钟显著升高(P<0.05),Ⅱ组SP在插管后显著升高,HR在插管后显著下降(P<0.05),Ⅲ组SP于插管后显著下降(P<0.05),DP于插管后1分钟显著下降(P<0.05);Ⅰ组SP、DP、HR拔管后1分钟显著升高(P<0.05),Ⅱ组HR拔管后10分钟均显著下降(P<0.05),SP拔管后3-9分钟则低于基础值(P<0.05),Ⅲ组HR拔管后5分钟显著升高(P<0.05),SP、DP拔管后3分钟显著下降(P<0.05)。结论:艾司洛尔和乌拉地尔均可有效降低应激引起的心血管反应。乌拉地尔用于单纯血压升高的病人有利,而艾司洛尔对于心率增快的病人更为有利。
Objective: To observe the influence of intravenous esmolol or urapidil on cardiovascular response and heart rate variability during general intubation and intubation. Methods: Sixty patients were randomly divided into three groups, 20 cases in each group. Group Ⅰ was control group, group Ⅱ was esmolol group, and group Ⅲ was urapidil group. The changes of SP, DP, HR, BIS, HRV in 3, 3, 4, 5, 6 and 10 minutes during intubation and extubation were observed. Results: SP and DP in group Ⅰ were significantly increased at 1 minute after intubation (P <0.05). SP in group Ⅱ was significantly increased after intubation, HR decreased significantly after intubation (P <0.05) After intubation, the DP decreased significantly (P <0.05), DP decreased significantly 1 min after intubation (P <0.05). In group I, the SP, DP and HR increased significantly 1 min after extubation (P <0.05) (P <0.05) at 10 minutes after extubation, and lower than the baseline at 3-9 minutes after extubation (P <0.05). In group Ⅲ, the HR at 5 minutes after extubation was significantly increased (P <0.05) SP, DP significantly decreased 3 minutes after extubation (P <0.05). Conclusion: Both esmolol and urapidil can effectively reduce the stress-induced cardiovascular response. Urapidil is beneficial for patients with elevated blood pressure alone, and esmolol is more beneficial for patients with increased heart rate.