| Owing to blood transfusion complications such as infectious disease have increased and blood resource becomes difficult to achieve in recent years, controlled hypotension has been more used in clinic. Most of those operations bleed urgently, have difficulty in handling and strongly cause stress reaction, often followed by arrhythmia, vital organs ischemia.,unstable hemodynamic and rehemorrhage. The risk of anesthesia is serious. Controlled hypotension can really reduce blood lose, but it isn't a physiology and disturbs the normal function of circulatory system If it can't be used suitablely, it will aggrevate the risk of operation and anesthesia. Previous abundant investigation mostly emphasized on impact of hemodynamic during controlled hypotension, while the endocrine changes and stress reaction are less mentioned. Therefore the objects and scope of controlled hypotension are narrow. Endothelin (ET) and Atrial natriuretic peptide (ANP) are two sorts of important endocrine peptides, modulate the cardiologic function and have a critical role incirculatory pathology. The content changes of ET and ANP during controlled hypotenson influence the normal circulatory fuction and patients' prognosis. So this experiment adapt three groups hypotensive drugs in meningioma radical surgery patients. Through monitoring the changes of hemodynamic ET and ANP 's content ,The aim is to observe: 1) Are there different effects between single and combined drugs during controlled hypotension. 2) Whether the content of ET ANP in blood and hemodynamic that influenced by different group drugs are different during controlled hypotension. 3) Finding a better hypotensive drug or combined drugs that little influence physiology. Provide the theoretical warranty in clinical anesthesia.Material and method: This experiment bring into thirty meningioma patients preparing for controlled hypotension. Male are 13 patients, and female 17 patients, ASA 1-2.All patients hadn't complications. Thirty patients were divided randomly into three groups, ten patients for each, undergoing controlled hypotension under oral intubated anesthesia. The induced anesthetics, analgesics and inspired anesthetic were all the same, but the drugs for controlled hypotension was different: 1) SNP (groupA, group comparison). 2) SNP combined NTG (groupB). 3) NC combined ESM (groupC). The blood samples were taken from peripheral vain before hypotension (T1), approach to target value of blood pressure (T2), 20 minutes after maintaining hypotension and 20 minutes after hypotension ended. The contentof ET and ANP in blood were measured. The numeric value of HR, MAP and CVP were recorded too.Result: Group A, B and C were compared before controlled hypotension: the content of ET and ANP were not distinguished significantly. Group A were compared with group B and C at T2: The content of ET were higher than that of in group C (ET: 55.67 +7.40pg/ml VS 49.98+7.55pg/ml,P<0.05;46.05+5.86pg/ml, P<0.01); The content of ANP in group A and B were lower than that of in group C (75.12+5.34pg/ml; 75.52+6.97pg/ml VS 85.67+6.98pg/ml, P<0.01),and there were not distinguished significantly between group A and B at T2. At T3, the changes of ET and ANP were similar to that of at T2,but the content of ET in group A increased faster than that of in group B (ET: 61.63 + 5.96pg/ml VS 55.67 + 7.40pg/ml, p<0.05).At T4,the content of ET and ANP in group A was obviously higher than that of in group B and C. Compared within each group: At Tl, the content of ET in group A was lower than that of at T2, T3, and T4 (ET: 45.72 + 5.27pg/ml VS 55.67 + 7.40pg/ml, 61.63+5.96pg/ml, 57.21 + 8.76pg/ml, P<0.01),and ANP were obvious higher than that of at T2, T3 and T4 (T2vsTl, pg/ml vs 88.79+ 9.47pg/ml,p<0.05;T3 vs Tl: 66.83 + 5.34pg/ml vs. 88.79 + 9.47pg/ml.p<0.01). In group B, the changes of ET, ANP is similar with group A. But at T4, the content of ET and ANP almost approach to that of at Tl.There were no statistically significant differences from that of at Tl (p>0.05); In group C, the content of tw...
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