全麻快诱导期非加压通气的可行性  

Feasibility of apnea during general anesthesia inducing period by propofol-rocuronium and rimifentyl

作　　者：张引法 黄冰[2] 李瑛[2] 俞丹红[2] 过建国[2] 罗永香[2] 

机构地区：[1]浙江嘉兴妇幼保健院麻醉科,嘉兴314000 [2]浙江嘉兴学院医学院附属嘉兴市第一医院麻醉科

出　　处：《临床医学》2006年第10期22-23,共2页Clinical Medicine

摘　　要：目的观察丙泊酚-爱可松-瑞芬太尼快诱导期非正压通气的可行性及对急性胃扩张的预防效果。方法20例择期全麻病人人手术室即作动脉血气分析，高流越（8—10L/min）吸氧5min后静注丙泊酚（2mg／kg）-爱可松（0．8mg／kg）-瑞芬太尼（1μg／kg）序贯快诱导（60s内注射完毕），60s后气管捅管。插话成功即刻再进行动脉m气分析。诱导插管期间任由患者进入无呼吸状态而不给予正压辅助通气。结果各病人诱导后插管条件满意，平均插管耗时27．45s。诱导插管后患者的PaO：、PaCO：均上升，与基础值相比分别为（242±111）Vs（93±10）mmHg（P〈0．01）和（45±8）Vs（39±4）mmHg（P〈0．01），无急性胃扩张发生。结论经5mill的高流谴纯氧预吸后，丙泊酚-爱可松-瑞芬太尼快诱导插管期无通气并无低氧、高碳酸血症的发生，且可有效防止诱导期急性胃扩张发生。Objective To estimate the feasibility of apnea during general anesthesia inducing period by propofol - roeuronium and rimifentyl. Methods Got artery blood for arterious bloodgas analyzed from 20 patients who appointed to undergoing general anesthesia just when they were set into operation room. After 5 minutes, high flow（ 8 - 10L/min） pure oxygen supply, anesthesia inducing were performed by intravenous in 60s with propofol （2mg/kg） - rocurouium （0.8 mg/kg） and rimifentyl （ 1μg/kg） , waiting for another 60s, applicated tracheal intubation, and the arterious blood gas analysis was peribrnled again. During inducing preiod,let the patients be apnea and gave no ventilation. Results Contrast to the baseline,the PaO2 and PaCO2 were（242 ± 111 ）Vs（93 ± 10）mm Hg（ P 〈0.01 ）and（45± 8）Vs（39 ±4）mm Hg（ P 〈0.01 ） ,respectively. Conclusion By pure oxygen supply, zero ventilation can be applicated safely during propofol- rocuroniium and rimifentyl inducing period.

关 键 词：全身麻醉 快诱导 氧疗 血气分析 

分 类 号：R614[医药卫生—麻醉学]