Abstract: ［Abstract］ Objective To investigate the effect of propranolol on analgesia and hemodynamics and postoperative adverse reactions in general cannula and extubation. Methods A total of 80 patients undergoing general anesthesia for tracheal intubation in our hospital aged 30-65 years with a body weight of 48-75 kg were enrolled in this study. ASA was classified as grade Ⅰ and grade Ⅱ. Randomly divided into： saline control group （control group） and propatinam group （experimental group）. The two groups were given intravenous drip of saline 100 mL or propatinol 2 g/100 mL 15 minutes before anesthesia respectively. Before tracheal intubation （T1）， 5 min after intubation （T2）， 5 min before extubation （T3）， immediately after extubation （T4）， extubation MAP （mean arterial pressure）， heart rate （HR） and central venous pressure （CVP） at 5 min （T5） were measured and analyzed by using CA-7000 automatic coagulation analyzer and ancillary reagents The two groups of patients were respectively treated with propantamil， platelet aggregation rate， prothrombin time （PT）， thrombin time （APTT）， partial prothrombin time （APTT） Fibrinogen concentration （FIB）. In addition， RS restlessness score， Ramsay sedation score and VAS score were used to assess perioperative and postoperative agitation， sedation and pain. Results There was no significant difference in HR， MAP and CVP between T1 and T3 in both groups （P>0.05）. Compared with T3 at T2， T4 and T5， MAP and HR in both groups increased， However， MAP and HR at each time point in the experimental group were significantly lower than those in the control group （P<0.05）. In addition， CVP in both groups only increased significantly in T4； PT， TT， APTT and FIB at each time point in both groups were not significantly different between groups and between groups. In addition， the RS and Ramsay scores of the test group after extubation were significantly lower than those of the control group， and the VAS scores at 1 h and 6 h were also lower than those of the control group. Conclusion The prophylaxis of propranolol in patients with general anesthesia can maintain the hemodynamics of intubation and extubation in patients with general anesthesia， which can reduce and reduce postoperative pain and do not affect patients Perioperative coagulation function， can be safely used for general anesthesia of the analgesic.

Key words: Propacetamol, Advanced analgesia, Hemodynamics, Blood clotting, General anesthesia

摘要： ［摘要］ 目的 探讨丙帕他莫超前镇痛对全麻插管与拔管期血流动力学及术后不良反应的影响。方法 选取在我院进行的气管插管全麻术的80例患者，分为2组各40例。对照组于麻醉前15 min静脉滴注生理盐水100 mL，试验组为生理盐水100 mL+丙帕他莫2 g。观察两组患者气管插管前（T1）、插管后5 min（T2）、拔管前5 min（T3）、拔管即刻（T4）、拔管后5 min（T5）的平均动脉压（MAP）、心率（HR）、中心静脉压（CVP），检测患者的血小板聚集率、凝血酶原时间（PT）、凝血酶时间（TT）、激活部分凝血酶原时间（APTT）、纤维蛋白原浓度（FIB）。采用RS躁动评分法、Ramsay镇静评分法及VAS法评估患者的围术期及术后的躁动、镇静、疼痛等情况。结果 两组患者HR、MAP、CVP于T1及T3期无显著性差异（P>0.05）；T2、T4、T5各时点与T3相比，两组患者的MAP和HR均有升高趋势（P<0.05），试验组各时点的MAP和HR均低于对照组（P<0.05）；各时间点比较，T4时点的CVP最高（P<0.05）。两组患者各时点的血小板聚集率、PT、TT、APTT、FIB比较差异均无统计学意义（P>0.05）。T3、T4、T5时点，试验组患者RS和Ramsay评分均低于对照组（P<0.05）。各时间点比较，T4时点的RS和Ramsay评分最高（P<0.05）。试验组患者拔管后1 h 和6 h的VAS评分低于对照组（P<0.05）。结论 丙帕他莫用于全麻术患者的超前镇痛，能较好维持全麻术患者的插管与拔管期血流动力学平稳，减轻术后疼痛，且不影响患者围术期的凝血功能，可安全用于全麻手术的超前镇痛。

关键词: 凝血, 血流动力学, 全麻术, 超前镇痛, 丙帕他莫