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目的探讨硝酸异山梨醇酯对经鼻气管插管血流动力学反应的影响。方法择期全身麻醉下行口腔颌面外科手术的患者80例,随机分为两组,每组40例,对照组麻醉诱导时复合应用生理盐水0.2 ml/kg,观察组麻醉诱导时复合应用硝酸异山梨醇酯70μg/kg。均采用直接喉镜经鼻明视气管插管。记录入室后5 min(基础值),注药后1 min,插管即刻,插管后1 min、2 min、3 min、4 min、5 min的收缩压(SBP)、舒张压(DBP)、心率(HR)。结果与基础值比较,麻醉诱导后两组SBP、DBP、RPP降低(P<0.05),气管插管时对照组SBP、DBP、RPP升高(P<0.05),观察组SBP、DBP、RPP升高(P>0.05),两组HR升高(P<0.05);与对照组比较,观察组SBP、DBP、RPP较低,两组差异有统计学意义(P<0.05)。结论成人麻醉诱导时复合应用硝酸异山梨醇酯70μg/kg可预防直接喉镜经鼻气管插管血流动力学反应。
Objective To investigate the effect of isosorbide dinitrate on the hemodynamic response to nasotracheal intubation. Methods Eighty patients undergoing oral and maxillofacial surgery undergoing elective general anesthesia were randomly divided into two groups (n = 40 in each group). The control group received 0.2 ml / kg NS combined with anesthesia induction. The rats in the observation group were treated with isosorbide mononitrate Alcohol ester 70 μg / kg. Direct laryngoscopes are used as nasogastric endotracheal intubation. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and blood pressure were recorded at 5 min after infusion, 1 min after injection, immediately after intubation, 1 min, 2 min, 3 min, 4 min and 5 min after intubation Heart rate (HR). Results SBP, DBP and RPP in the two groups decreased after anesthesia induction (P <0.05), SBP, DBP and RPP in the control group increased after tracheal intubation (P <0.05) (P <0.05). The HR of both groups increased (P <0.05). Compared with the control group, SBP, DBP and RPP of the observation group were lower, the difference was statistically significant (P <0.05). Conclusions Adult isoflurane combined with isosorbide dinitrate 70μg / kg can prevent hemodynamics of nasopharyngeal tracheal intubation with direct laryngoscopy.