三磷腺苷对全身麻醉苏醒拔管期心血管反应的影响

    Effects of triphosadenine on preventing cardiovascular responses during extubation awakening period after general anesthesia

    • 摘要: 目的:观察三磷腺苷(ATP)对全身麻醉(全麻)苏醒拔管期心血管反应的影响。方法:选择ASAⅠ~Ⅱ级全麻手术患者40例,随机分为观察组和对照组,每组各20例。观察组于术毕拔管前5 min缓慢静脉注射ATP 0.3 mg/kg,对照组拔管期不用任何药物,记录拔管前5 min、拔管时、拔管后1、3、6 min各时点的收缩压(SBP)、舒张压(DBP)、心率(HR)、平均动脉压(MAP),并计算出收缩压与心率乘积(RPP)。结果:拔管前5 min 2组各项指标值比较差异无统计学意义(P>0.05)。观察组拔管时及拔管后1、3、6 min,其SBP、DBP、MAP、HR与拔管前5 min比较差异均无统计学意义(P>0.05),RPP仅在拔管时增加(P<0.05)。对照组在拔管时、拔管后1 min与拔管前5 min比较SBP、DBP、MAP、HR、RPP均显著升高(P<0.05~P<0.01),拔管后3 min与拔管前5 min比较SBP、MAP、HR、RPP显著升高(P<0.05~P<0.01),拔管后6 min各项指标值接近拔管前5 min水平(P>0.05)。观察组在拔管时、拔管后1、3 min各项指标明显低于对照组(P<0.05~P<0.01)。结论:ATP可有效预防全麻手术苏醒拔管期的心血管反应。

       

      Abstract: Objective: To observe the effects of triphosadenine (ATP) on preventing cardiovascular responses to endotracheal extubation when a patient came to his consciousness from general anesthesia.Methods: Forty patients (ASA Ⅰ toⅡ) undergone general anesthesia were randomly allocated to observation and control group with 20 cases in each.The patients in observation group were given intravenous drip with ATP at a dose of 0.3 mg/kg 5 min prior to extubation,whereas the patients in control group were received no medication.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and mean arterial pressure (MAP) were recorded at 5 min before extubation,during extubation,at 1,3 and 6 min after extubation,and RPP was determined.Results: The indexes at 5 min before extubation in the two groups showed no significant difference (P>0.05).There were no significant differences in SBP,DBP,MAP and HR between 5 min before extubation and during extubation,at 1,3 and 6 min after extubation in observation group (P>0.05),and RPP was increased only in extubation time (P<0.05).Compared with 5 min before extubation,all indexes were significantly increased during extubation,at 1 min after extubation in control group (P<0.05-P<0.01),and the value of SBP,MAP,HR and RPP were significantly increased at 3 min after extubation,too (P<0.05-P<0.01).All indexes at 6 min after extubation were similar to the level 5 min before extubation in control group (P>0.05).All indexes in observation group were significantly decreased during extubation,at 1 min and 3 min after extubation compared with control group (P<0.05-P<0.01).Conclusions: ATP can prevent patients from cardiovascular response effectively when patients are in condition of extubation in palinesthesia.

       

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