[The clinical application of compound induced hypotension during functional endoscopic sinus surgery].

Tao Wu, Jun Yang, Kai Luo, Yingwei Wang, Xinmin You
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Abstract

Objective: To assess the clinic efficacy of compound induced hypotension during functional endoscopic sinus surgery.

Method: Sixty patients with chronic sinusitis and nasal polyps were divided into three groups: Sodium nitroprusside (SNP) group (A), diltiazem+SNP group (B), labetalol+SNP group (C). We started induced hypotension with beginning of functional endoscopic sinus surgery. Mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI) and ejection fraction (EF) were recorded during induced hypotension. Sugar and lactic acid in arterial and venous blood were also assayed. Then we calculate rate-pressure product (RPP), arteriovenous difference in blood glucose [D(v-a) BG], blood glucose extraction rate (BGER), arteriovenous difference in lactate [L(v-a)] and lactate produce rate (LPR).

Result: The dose of SNP applied in group B and C are fewer than group A ( P <0. 05). The cardiovascular functions and body metabolism of the patients in group B and C were stable and the anesthetic effect was satisfactory. Few adverse reaction of the drug was found in present study.

Conclusion: Induced hypotension with SNP compound of diltiazem or labetalol is an ideal way in clinical use and produce satisfied synergistic effect.

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【复合诱导降压在功能性内镜鼻窦手术中的临床应用】。
目的:评价功能性鼻窦内镜手术中复合诱导降压的临床疗效。方法:将60例慢性鼻窦炎合并鼻息肉患者分为硝普钠(SNP)组(A)、地尔硫卓+SNP组(B)、拉贝他洛尔+SNP组(C),从功能性鼻窦内窥镜手术开始诱导降压。记录诱导性低血压时的平均动脉压(MAP)、心率(HR)、心输出量(CO)、心脏指数(CI)和射血分数(EF)。同时测定动脉血和静脉血中的糖和乳酸。然后计算速率压积(RPP)、动静脉血糖差[D(v-a) BG]、血糖提取率(BGER)、乳酸动静脉差[L(v-a)]和乳酸生成率(LPR)。结果:B、C组SNP用量均小于A组(P)。结论:SNP复合地尔硫卓或拉贝他洛尔诱导降压是临床应用的理想方式,可产生满意的增效效果。
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