Application Of Controlled Hypotension With Urapidil On Endoscopy Operation

[Objective] To explore the feasibility of controlled hypotension with Urapidil on Endoscopy operation[Methods] Forty ASAâ… -â…¡patients ,ages range from 20 to 60,undergoing selective Endoscopy Opration were enrolled in the study. The patients were randomly divided into groupâ… (URA) and groupâ…¡(NTG). Two groups of patients use the same anesthesia induction and method of maintainable operation. To maintain arteral pressure(MAP) was reduced by 30%-40%. MAP,HR,SPO₂,P_ETCO₂were recorded before anesthesia induction(T₁), before hypotension(T₂), blood pressure reach to predicted value(T₃), at 5 min(T₄),10min(T₅),20 min (T₆)and 30 min(T₇) after blood pressure reach to predicted value, 10 min after ceasing hypotension(T₈). At each pointT₃,T₄,T₅,T₆,T₇ use Fromme standerd surgery field quality(SSFQ) for the score; And at each point T₂,T₇ record jugular vein bulbar zone lactic acid (LD_jv) ,arterial blood glucose ( BG_a) ,jugular vein bulbar zone blood glucose (BG_jv) ,caculate the blood glucose difference between artery and jugular vein bulbar zone [D_(a-jv) BG] and brain glucose uptake rate (BGER) ,measure ANP and ACTH .[Results] As compared with T₂, MAP decreased apparently in groupâ… and groupâ…¡at T₃, T₄, T₅, T₆, T₇(P＜0.01) and raised up apparently in groupâ…¡at T₈(P＜0.01). Take T₁ to compare with T₂ ,there was no significant change in MAP in both groups (P＞0.05). As compared with groupâ… , MAP increased apparently at T₈ in groupâ…¡(P＜0.01). Heart rate didn't increased significantly at T₃, T₄, T₅, T₆, T₇ compared with T₂ in groupâ… during hypotension,but it increased in groupâ…¡(P＜0.01). Heart rate increased significantly at T₃, T₄, T₅, T₆, T₇ In groupâ…¡compared with groupâ… .The field of vision in operation was much better in groupâ… (P＜0.05).At T₇, ANP, ACTH,BGa and BGjv was apparently higher than T₂ in both groups(P＜0.05, P＜0.01). There was not significant difference in D(a-jv)BG and BGER between the two groups. (P＞0.05). At T₇. LDjv did not decreased significantly during hypotension compared with T₂ in groupâ… and groupâ…¡(P＞0.05).[Conclusio] Both Urapidil Hydrochloride and NTG can work well and have no great influence on cerebral oxygen supply-requirement balance and cerebral metabolism during the period of controlled hypotension on Endoscopy operation. While the former one has better surgery field quality and more stable on hemodynamics.