Effect Of Urapidil Vs. Nitroglycerin Treatment On Pituitrin-induced Hemodynamic Changes In Laparoscopic Myomectomy

Objective The efficacy of urapidil and nitroglycerin in treatment of pituitrin-induced hemodynamic changes was compared in patients undergoing laparoscopic myomectomy.Methods The patients with ASA?or ?scheduled for laparoscopic myomectomy were injected with 6U pituitrun beside hysteromoma.If their blood pressure was more than 160/95 mm Hg or 20% of basic pressure in 5 minutes after injection,they were included into this study and randomly assigned into two groups: nitroglycerin group?group N,n=29?and urapidil group?group U,n=28?.5 minutes after pituitrin injection,nitroglycerin was infused intravenously?5¹0?g/min?by pump for 30 minutes continuously in group N,while urapidil?0.5mg/kg?was injected intravenously in group U.Patients' characteristics such as age,weight and height were collected.The systolic pressure?SBP?,diastolic pressure?DBP?,mean blood pressure?MAP?and heart rate?HR?were recorded before anesthesia?T₀?,at once?T₁?of pituitrin injection and 5min?T2?,10min?T₃?,20min?T₄?,30min?T₅?after injection and the time out of operation room?T₆?.The operation time,anesthesia time,the amount of bleeding and urinary volume were also measured.Results Patients' characteristics were similar between group N and U.The SBP significantly increased at T2 and T₃ compared with that at T₀?p<0.05?in group N,which also increased at T2-4?p<0.05?in group U.The SBP in group U was significantly higher than group N at T₄ and T₅?p<0.05?.The DBP increased at T2-5?p<0.05?as compared with that at T₀ in group N and U.Compared with group N,the DBP in group U was significant higher at T₆?p<0.05?.The MAP significantly increased at T2-4 as compared with that at T₀ in both group?p<0.05?.The MAP was not significantly different at each time point between group N and group U.There were no significant differences of HR at each time point in group N,while the HR at T₁-5 was lower than T₀ in group U?p<0.05?.To compare with group N,the HR in group U was significantly higher at T₀?p<0.05?,but lower at T₃,T₄ and T₅?p<0.05?.The two groups had no significant differences in operation time,anesthesia time,blood loss and urine volume.Conclusion Compared with urapidi,nitroglycerin can more effectively reduce pituitrin-induced hemodynamic changes in laparoscopic myomectomy.