不同剂量芬太尼诱导与围术期呼气末安氟醚浓度的关系  

Relationship Between Fentanyl with Different Doses During Anesthesia Induction and Perioperative End-tidal Concentration of Enflurane

作　　者：曾力行[1] 路璐[1] 周华[1] 

机构地区：[1]湖南省怀化市第一人民医院麻醉科,湖南怀化418000

出　　处：《医学临床研究》2007年第9期1536-1538,共3页Journal of Clinical Research

摘　　要：【目的】探讨以不同剂量的芬太尼静脉诱导,患者围术期呼气末安氟醚浓度的变化关系。【方法】将60例择期全麻下手术的患者(ASAⅠ～Ⅱ级),随机分成三组,诱导用药依次为咪唑安定0.1mg/kg,丙泊酚1mg/kg,卡肌宁0.6mg/kg及芬太尼。芬太尼剂量为Ⅰ组1μg/kg,Ⅱ组2μg/kg,Ⅲ组3μg/kg。观察并记录诱导后10min、20min、30min时维持平均动脉压的波动在诱导前对照值±10%时安氟醚呼气末浓度(Et)。观察期间,仅通过调整安氟醚的浓度控制血流动力学参数,不用任何其他麻醉药物,也不用任何影响血压、心率的药物。【结果】Ⅰ组病人呼气末安氟醚浓度最高,才能维持平均动脉压在术前水平,而Ⅲ组Et极低,即能维持血流动力学稳定和麻醉深度,Ⅱ组位于二者之间,组间比较差异有统计学意义(P<0.05)。【结论】以芬太尼静脉诱导时,随所用的芬太尼剂量的增加,呼气末安氟醚浓度逐渐下降,3μg/kg芬太尼静脉诱导组时,只需极小呼气末安氟醚浓度,即能维持血流动力学稳定及适当的麻醉深度。To investigate the relationship between fentanyl with different doses during intravenous induction and perioperative end-tidal concentration（Et） of enflurane. [Methods]60 patients , ASA classⅠ～Ⅱ, undergoing general anesthesia , were randomly divided into three groups by the doses of fentanyl; 1μg/ kg, 2 μg/kg, 3 μg/kg. Induction drugs were midazolam 0.1 nag/kg,propofol 1 mg/kg, tracium 0.6 mg/kg and fentanyl by turns. The dosage of fentanyl in group Ⅰ , Ⅱand Ⅲ was respectively 1 μg/kg, 2 μg/kg and 3 μg/ kg. End-tidal concentration of enflurane was recorded and observed in 10 min ,20 min,30 min after induction. I^Results]End-tidal concentration of enflurane in group I , which could maintain average arterial pressure at pre-operative level, was the highest ,and that in group Ⅲ, which could maintain the stability of hemodynamics and the depth of anesthesia, was the lowest, and that in group II was between group I and group Ⅲ. There was significant difference（ P〈0.05）. HR was significantly decreased in group Ⅲ. [Conclusion]With the increasing of fentanyl in intravenous induction, end-tidal concentration of enflurane is gradually decreased. Induction combined with fentanyl of 3 μg/kg can keep balanced hemodynamics and proper anesthesia depth when enflurane requirement is very low.

关 键 词：恩氟烷 芬太尼/投药和剂量 

分 类 号：R971.1[医药卫生—药品]