新疆医科大学学报JOURNAIOFXINJIANGMEDICAlUNIVERSITY2009Feb．，32(2)201不同药物预防全麻拔管期间心血管反应的观察张秦，陈春玲(新疆医科大学第一附属医院麻醉科，新疆鸟鲁木齐830011)摘要：目的：观察利多卡因、曲马多、乌拉地尔用于预防拔除气管导管期间心血管反应的作用。方法：将6o例拟在气管插管、静吸复合全麻下行择期上腹部手术患者随机分为成利多卡因组、曲马多组、乌拉地尔组及对照组4组，每组15例。符合拔管指征时4组患者分别静推利多卡因(1mg／kg)、曲马多(50mg)、乌拉地尔(12．5mg)及生理盐水(2m1)，3min后拔除气管导管。记录诱导前、拔管前、拔管时、拔管后3、5、10min各时点患者的心率(HR)、收缩压(SBP)、舒张压(DBP)的值。结果：拔管后曲马多组、乌拉地尔组的HR、SBP和DBP与对照组相比均较低，差异有统计学意义(P<O。05)。且曲马多比其它3组更能维持皿流动力学平稳。结论：曲马多、乌拉地尔均可有效预防全麻拔管期问心血管反应，且曲马多效果更佳。关键词：利多卡因；曲马多；乌拉地尔；心血管反应；气管拔管中圈分类号：R614；R54文献标识码：A文章编号：1009—5551(2009)02—0201—03ComparisonoftheEffectsofdifferentdrugsonattenuationofcardiovascularresponsestotrachealextubationZHANGQin，CHENChun—ling(DepartmentD，AnPsfPsoZog，FirstAffiliatedHospital，XinjiangMedicalUniversity，Urumqi8300ll，China)Abstract：Objective：Toobservetheeffectsoflidocaine，tramadolhydrochlorideandurapidilinsuppressingthecardiovascularresponsesduringtrachealextubation．Methods：Sixtyadultpatients(ASAphysicalsta—tusI～Ⅱ)whoschduledtoundergoelectiveabdominalsurgerywererandomlyenrolledtooneoffourgroups(一15each)．Patientsreceivedeither，lidocaine1mg／kgIV，tramadolhydrochloride50mgIV，urapidil12．5mgⅣ，normalsaline2mlⅣ，beforetrachealextubation．Thesemedicationsweregivenin3rainbeforetrachealextubation．ThechangesofHRandSBP，DBPwererecordedindifferenttime．Thatwerebeforeinduetion，beforeextubation，atextubation，and3，5，10minafterextubation．Results：SBP，DBPandHRafterextubationintramadolhydrochloridegroupandurapidilgroupwerelowerthaninnor—malsalinegroup．Therewerestatisticalsignificance．Thehemodynamicsintramadolhydroehloridegroupwasmorestablethanothergroups．Conclusion：Bothtramadolhydrochlorideandurapidilcanattenuatecardiovascularresponseduringtrachealextuhation．Tramadolhydrochlorideisthebestchoiceduringtra—chealextubation．Keywords：1idocaine；tramadoJhydrochloride；urapidil；cardiovascularresponse；trachealextubation气管内插管全麻苏醒期间麻醉状态减浅，气管拔管时的心血管反应，但究竟何种药物效果更导管对气管及咽喉部的刺激增加，与气管插管一样，佳，尚未报道。本研究比较利多卡因、曲马多和乌拉常弓l起血压升高和心动过速等0。因吸痰、拔管可地尔对拔管期间