雷米芬太尼对全麻诱导气管插管心血管反应的影响  

EFFECT OF REMIFENTANIL ON CARDIOVASCULAR RESPONSE CAUSED BY TRACHEAL INTUBATION IN GENERAL ANESTHESIA

作　　者：左永文[1] 周平[2] 唐显玲[1] 

机构地区：[1]泸州医学院附属医院麻醉科,四川省泸州市646000 [2]泸州市中医医院麻醉科

出　　处：《中国煤炭工业医学杂志》2006年第5期423-424,共2页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨雷米芬太尼对全麻诱导气管插管心血管反应的影响。方法选择择期ASAⅠ～Ⅱ级患者90例，随机分为雷米芬太尼组（RF组）、芬太尼1组（F1组）和芬太尼2组（F2组）三组，每组30倒。麻醉诱导采用静注咪唑安定0．05～0．1mg／kg，丙泊酚1～2mg／kg，RF组缓慢注射雷米芬太尼2～3μg／kg（时间〉1min），F1组注射芬太尼2μg／kg，F2组注射芬太尼4μg／kg。三组均注射堆库溴胺0．1mg／kg，2min后气管插管。观察三组惠者诱导前、诱导后、气管插管后0，1，3，5min的血压和心率变化。结果三组患者全麻诱导后。气管插管前的血压和心率与诱导前的血压和心率比较差异无统计学意义（P〉0．05）。F1、F2组气管插管后0，1，3min的血压和心率明显地升高，与诱导前的血压和心率比较差异有统计学意义（P〈0．01），RF组气管插管后0，1，3min的血压和心率无明显变化，与诱导前的血压和心率比较差异无统计学意义（P〉0．05）。RF组气管插管后0，1，3min的血压和心率较F1、F2组低，差异有统计学意艾（P〈0．01）。结论雷米芬太尼能明显地抑制全麻谤导气管插管的心血管反应，且不影响术后患者的苏醒。Objective To explore the effect of remifentanll on cardiovascular response caused by tracheal intubation in general anesthesia. Methods 90 ASA Ⅰ～Ⅱ elective surgery operation patients were divided randomly into remifentanil group （RF group）,fentanyl 1 group（F1 group） and fentanyl 2 group（F2 group）. Anesthesia were induced by midazolam 0. 05mg/ kg and propofol 1- 2mg/kg, RF group still added remifentanil 2- 3ug/kg （〉min）, F1 group and F2 group still added fentanyl 2ug/kg and 4μg/kg, all these drugs were injected by vein. Tracheal intubation was performed 2 minutes after vecunium 0.1 mg/kg intravenous injection. The changes of blood pressure （BP） and heart rate （HR） before and after anesthesia induction and 0,1,3,5 minutes after tracheal intubation were observed. Results Either BP or HR after anesthesia induction but before tracheal intubation showed no significant difference when compared with those of before anesthesia induction in three groups （P〉0.05 respectively）. Compared with before anesthesia induction, the BP and HR of 0, 1 and 3 minutes after tracheal intubation increased significantly in F1 group and F2 group （P〈0.01 respectively）, but changed little in RF group （P〉0.05 respectively）. At 0, 1 and 3 minutes after tracheal intubation, the BP and HR of RF group were much lower than those of F1 group and F2 group （P〈0.01 respectively）. Conclusion Remifentanil could inhibit obviously the cardiovascular response caused by tracheal intubation in general anesthesia and influence little sense of the patients covered from the general anesthesia.

关 键 词：雷米芬太尼 气管插管 心血管反应 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]