摘要
动脉导管未闭(PDA)手术的主要危险是出血,预防的方法是降压。现使用的硝普钠(SNP)存在引起反射性心动过速、耐药及潜在氰化物中毒的同题。为此,作者在60例PDA手术中进行降压观察,其中一部分加用不同剂量的普萘洛尔(心得安)或硬膜外阻滞。结果证明,普萘洛尔20μg/kg合用SNP和硬膜外阻滞合用SNP两种降压方法均能显著减少硝普钠用量。
The hypotensive effects of sodium nitroprusside (SNP) combined with intravenous propranolol (PPL) or epidural blockade were studied in 60 patients for surgical correction of patent ductus arteriosus (PDA). The patients were randomly divided into four groups: (1)Control group (n=20), patients recieving SNP infusion only; (2) Small dose PPL group (n=20), a single dose of 20 μg.kg~(-1) of PPL was given intravenously before SNP infusion; (3) Large dose PPL group (n=10), the procedure was the same as in group 2 except the dose of PPL was 39.0±8.8 μg.kg~(-1); (4) Epidural blockade was combined with SNP infusion (n=10).
The results showed that in all of the four groups systolic blood pressure was decreased to 10.67～12.00 kPa (80～90mmHg), but the maximal minute dose and the total dose of SNP were reduced by 69.4% and 60.4% in group 2, and by 73.6% and 73.6% in group 4 respectively compared to those in control group. On the contrary, SNP requirements could not be significantly reduced in group 3. The heart rates increased by 10.6% in group 1 and decreased by 7.5%, 12.8% and 13.7% in group 2, 3 and 4 respectively.
It is concluded that SNP supplemented with β-hlocker PPL or epidural blockade for the induction of hypotension during PDA operation is more efficient than SNP infusion alone, the appropriate dosage of PPL is around 20 μg.kg~(-1).
出处
《中国循环杂志》
CSCD
1991年第4期285-287,共3页
Chinese Circulation Journal
关键词
动脉导管未闭
硝普钠
手术
Patent ductus arteriosus
Induced hypotension
Sodium nitroprusside
Propranolol
Epidural blockade
