右美托咪定复合尼卡地平用于鼻内镜手术控制性降压临床研究

摘要

Objective To study the efficacy of dexmedetomidine combined with nicardipine on the controlled hypotension in nasal endo-scopic surgery. Methods 40 cases of hospitalized patients waiting for nasal endoscopic surgery were randomly divided into 2 groups:nicardipine group ( group N, n=20 ) and dexmedetomidine combined with nicardipine group ( group YN, n=20 ) . The MAP, HR and the blood lactic acid value ( LAC ) were monitored before the hypotension ( T0 ) , 10 min ( T1 ) , 20 min ( T2 ) and 30 min ( T3 ) after the hy-potension, the end of hypotension ( T4 ) and the 10 minutes after the end of hypotension ( T5 ) , and the operation time, extubation time, the dosage of nicardipine, intraoperative blood loss, the surgical field quality score and the MAP recovery time were recorded respective-ly. Results Compared with group T0, the blood pressure of T1-T5 in group N and T1-T4 in group YN decreased significantly ( P 0．05)；YN组出血量较 N组明显减少，术野质量评分低( P<0．05)；YN组尼卡地平用量较N组明显减少( P<0．05)；YN组MAP恢复时间较N组明显缩短( P <0．05)。结论盐酸右美托咪定与尼卡地平联合使用可有效降低不良反应发生情况，减少术中出血量，不影响重要器官灌注，提高了围术期安全性，值得临床推广。