硝酸甘油或硝普钠复合艾司洛尔用于控制性降压对兔椎静脉血流的影响

发布时间：2018-08-05 11:16

【摘要】：目的观察控制性降压时兔椎静脉血流的变化,探讨不同控制性降压方法对椎静脉血流的影响。方法成年健康新西兰兔18只,随机分为三组,每组6只。S组维持MAP于(90±5)mm Hg。GTN组采用硝酸甘油0.5μg·kg~(-1)·min~(-1)、艾司洛尔2.5μg·kg~(-1)·min~(-1)(硝酸甘油∶艾司洛尔为1∶5的复合液)行控制性降压,将MAP降低至基础值的(70±10)%。SNP组采用硝普钠0.5μg·kg~(-1)·min~(-1)、艾司洛尔2.5μg·kg~(-1)·min~(-1)(硝普钠∶艾司洛尔为1∶5的复合液)行控制性降压,将MAP降至同一目标值。于静脉全麻下建立控制性降压模型,采用Terason 2 000彩色超声系统分别在降压前、降压稳定后1h测量兔椎静脉血流量。结果降压前三组MAP分别为:S组(89.0±5.2)mm Hg,GTN组(91.5±9.6)mm Hg,SNP组(92.0±5.7)mm Hg,组间差异无统计学意义。S组实验前后血压无明显变化;GTN组与SNP组降压后血压差异无统计学意义,但均比降压前明显下降(P0.05)。控制性降压后,GTN组与SNP组椎静脉血流量明显少于S组,GTN组明显少于SNP组(P0.05)。结论在本实验选定的药物配比剂量内,硝酸甘油复合艾司洛尔比硝普钠复合艾司洛尔能更有效地降低椎静脉血流,可能更适用于脊柱手术的术中控制性降压。
[Abstract]:Objective to observe the changes of vertebral venous blood flow in rabbits with controlled hypotension and to explore the effect of different controlled hypotension methods on vertebral venous blood flow. Methods 18 healthy adult New Zealand rabbits were randomly divided into three groups. Group S maintained MAP at (90 卤5) mm Hg.GTN with nitroglycerin 0.5 渭 g kg ~ (-1) min ~ (-1) and esmolol 2.5 渭 g kg ~ (-1) min ~ (-1) (nitroglycerin: esmolol 1:5 compound solution) for controlled hypotension. In the SNP group, sodium nitroprusside 0.5 渭 g kg-1 min-1 and esmolol 2.5 渭 g kg-1 min-1 (sodium nitroprusside: esmolol) were used to control hypotension and MAP was reduced to the same target value. A controlled hypotension model was established under general intravenous anesthesia. The Terason 2000 color ultrasound system was used to measure the vertebral venous blood flow before hypotension and 1 hour after stable hypotension in rabbits. Results there was no significant difference in blood pressure between the three groups before hypotension (89.0 卤5.2) mm MAP and (91.5 卤9.6) mm) mm Hg,. There was no significant difference in blood pressure between the three groups before and after hypotension. There was no significant difference in blood pressure between GTN group and SNP group, but they were significantly lower than those before hypotension (P0.05). After controlled hypotension, the vertebral venous blood flow in GTN group and SNP group was significantly less than that in SNP group (P0.05). Conclusion the combination of nitroglycerin and esmolol is more effective than sodium nitroprusside combined with esmolol in reducing the blood flow of vertebral vein, and it may be more suitable for intraoperative hypotension in spinal surgery.
【作者单位】：广西医科大学第一附属医院麻醉科;
【基金】：广西自然科学青年基金项目(2014jjBA40070)
【分类号】：R614

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