摘要
目的观察瑞芬太尼与硝普钠控制性降压期间心率变异性(HRV)变化。方法42例行鼻内镜手术患者,随机分为瑞芬太尼组(R组)20例和硝普钠组(N组)22例。分别泵入瑞芬太尼或硝普钠,将收缩压降低基础值的30%左右。记录降压前、降压过程中及复压前后低频(LF)、高频(HF)、低高频比值(LF/HF)及收缩压(SBP)、心率(HR)。结果①与降压前相比:降压期间两组LF、HF均下降;R组LF/HF下降,但N组LF/HF升高(P<0.05,P<0.01);复压后两组LF、HF均回升至降压前水平(P>0.05),但R组LF/HF仍低于降压前水平(P<0.01),N组LF/HF回升至降压前水平(P>0.05)。②降压期间R组HR较降压前减慢,N组HR明显增快(P<0.01);复压后R组HR无明显变化,N组HR明显减慢(P<0.01);R组HR与LF/HF呈正相关关系(P<0.01),N组HR与LF、HF呈负相关关系,与LF/HF呈正相关关系(P<0.01)。结论R组降压时迷走神经张力下降的幅度小,HR较降压前减慢;N组降压时交感神经张力下降的幅度小,HR明显增快;复压后R组交感迷走神经张力均衡性未改变,HR无明显变化,N组迷走神经张力增高的幅度大,HR明显减慢。
Objective To investigate the effect of controlled hypotension with remifentanil or sodium nitroprusside on HRV. Methods Forty-two patients undergoing fuctional endoscopic sinus surgery were randomily dividied into group R or group N, and were infused with remifentanil or sodium nitroprusside respectively. The infusion velocity was adjusted according to the systolic blood pressure level. LF, HF, LF/HF, SBP and HR were monitored respectively at the follow intervals： before or during controlled hypotension, and after SBP restoration. Results ①During controlled hypotension,LF and HF of two groups and LF/HF of group R became lower, but LF/HF of group N was higher （P〈O.05, P〈O.OI ）; After SBP restoration, LF,HF of two groups and LF/HF of group N recovered to the level of before controlled hypotension （P〉O.05） while LF/HF of group R was lower （P〈O.OI）. （~） During controlled hypotension,HR of group R was siginificently slower while HR of group N became faster（P〈O.Ol ）, After SBP restoration, HR of group R remained the same（P〉O.05 ）while HR of group N was siginificently slower （P〈O.OI）. There were positive correlation between HR and LF/HF of group R and group N, while HR of group N is negatively correlated with LF,HF（P〈O.O1 ）. Conclusions During controlled hypotension, there is a less depression of parasympathetic nerve tone in group R and on sympathetic nerve tone in group N, After SBP restoration,the balance between sympathetic and parasympathetic nerve tone in group R remain unchanged and the parasympathetic nerve tone has more prominant increase in group N.
出处
《北京医学》
CAS
2006年第2期87-89,共3页
Beijing Medical Journal
