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目的 :比较小儿动脉导管未闭 (PDA)手术不同麻醉方法对硝普钠 (SNP)降压效果的作用。方法 :选择 6 0例 3～ 12岁施行手术患儿 ,随机分成两组 ;观察两组达到理想控制降压所需SNP的平均最大剂量 ,以及降压过程伴随的心率 (HR)、心率收缩压乘积 (RPP)变化。结果 :与Ⅱ组对比Ⅰ组SNP用量显著降低 (为 2 47± 2 2 0 μg·kg 1·min 1) ;降压期间Ⅱ组HR明显增快 (P <0 0 5 ) ,RPP显著增高 (P <0 0 5 ) ;麻醉期间Ⅰ组Isof吸入浓度显著低于Ⅱ组 (P <0 0 5 )。结论 :采用全麻加硬膜外或骶管阻滞可增强SNP的降压效果 ,减少其用量和副作用 ,提高了SNP的使用安全性。
Objective: To compare the effects of different anesthesia methods on the antihypertensive effects of sodium nitroprusside (SNP) in pediatric patients with patent ductus arteriosus (PDA). Methods: Totally 60 children aged 3 to 12 years who underwent surgery were randomly divided into two groups. The mean maximum dose of SNP needed to achieve optimal control of blood pressure and the heart rate (HR), heart rate systolic pressure Product (RPP) changes. Results: Compared with group Ⅱ, the dosage of SNP in group Ⅰ was significantly lower (247 ± 220 μg · kg -1 · min -1); HR in group Ⅱ was significantly increased (P <0.05) and RPP was significantly increased P <0.05). The inhaled concentration of Isof in group I during anesthesia was significantly lower than that in group II (P <0.05). Conclusion: Anesthesia plus epidural or sacral blockade can enhance the antihypertensive effect of SNP, reduce the dosage and side effects, and improve the safety of SNP.