Preoperative Applicating Urapidil Effect On Pituitrin Induced Hemodynamic Changes In Laparoscopic Uterine Fibroids Stripping Operation

ObjectiveTo investigate effects of preoperative applicating urapidil on Pituitrin induced hemodynamic changes in laparoscopic uterine fibroids stripping operation. Method76 Patients with fibroid who were treated in Obstetrics and Gynecology Department, general surgery Department, thoracic surgery Department, Urology Department, vascular surgery Department in our hospital from Jan,2012 to Mar, 2014 were selected as research object, according to random number table method, they were divided into U1group(urapidil 0.3mg/kg), U2 group(urapidil 0.5mg/kg) and U3 group(urapidil 0.8mg/kg) and group control(no urapidil), there were 19 patients in each group. the central venous pressure(CVP), the systolic blood pressure(SP), diastolic blood pressure(DP), averagearterial pressure(MAP), heart rate(HR), cardiac index(CI)and cortisol concentration changes before anesthesia(T0), Ye Suqian(T1) after injection of pituitaryposterior lobe of the pituitary gland, injection administration of lmin(T2), 4min(T3), 10min(T4) 30min(T5) among four groups were compared.At the same time the incidence of cardiovascular response during T2 ~ 4 after dose pituitrin and the SP,DP, MAP or HR wave occurrence rate of over 20% than T0 were observed. ResultsThe operation time, pneumoperitoneum, muscle relaxant among four groups had no significant difference(P>0.05).In control group, U1 group, the SP、DP、MAP、HR were significantly higher than those at T0.the SP, DP, MAP, HR between U2 group, U3 group at different time points had no obvious change. Among U1 group, U2 group, U3 group,the DP,MAP, SP HR at T2, T3,T4 were significantly lower than those in control group,the SP, DP, MAP, HR at T2, T3, T4 in U2 group or in U3 group were significantly lower than those in U1 group(P<0.05).The CVP at T1, T2, T3, T4, T5 in control group,or U1 group, or U2 group, or U3 group were significantly higher than those at T0(P<0.05),the CVP at T2,T3, T4 in U1 group was significantly lower than that in control group(P<0.05), the CVP at T1, T2, T3, T4 in U2 group, or U3 group, was significantly lower than that in control group(P<0.05), the CVP at T2, T3, T4 in U2 group, or U3 group were lower than that in U1group(P<0.05).The CI at T2, T3 in control group was higher than that at T0. at T5 was lower than that at T0. the CI at T2, T3, T4, T5 in U1 group, U2 group, U3 group and control group had no significant differences. The cortisol levels at different time points among four groups had no significantdifferences.The cardiovascular response rate In control group was the highest, U1 group followed up, that in U3 group was the lowest, the cardiovascular reactions among four groups had significant differences(P < 0.05). ConclusionsUrapidil can reduce cardiovascular responses in patients who has injected pituitary during laparoscopic uterine fibroids stripping operation.the effect with increase of dose is better, it is refer to our research results, we considers selecting 0.8mg/kg dose can obtain better effect.