七氟醚及丙泊酚分别复合瑞芬太尼诱导用于纤支镜气管插管比较  

Comparison of sevoflurane and propofol in combined anesthesia induction with remifentanil for tracheal intubation with fiberoptic bronchoscope

作　　者：谭红鹰[1] 操隆辉[1] 黄婉[1] 钟忠健[1] 林文前[1] 曾维安[1] 

机构地区：[1]中山大学肿瘤防治中心麻醉科/华南肿瘤学国家重点实验室,广东广州510060

出　　处：《南方医科大学学报》2010年第8期1857-1859,共3页Journal of Southern Medical University

基　　金：广东省科技计划项目(2009B030801161)

摘　　要：目的比较七氟醚(SEV)与丙泊酚(PRO)复合瑞芬太尼麻醉诱导,用于纤支镜(FOB)气管插管的效果及血流动力学。方法 24例需择期气管插管全麻手术而预计气道插管无困难患者,随机分为SEV组及PRO组,分别以七氟醚或丙泊酚复合瑞芬太尼诱导下行FOB插管。记录诱导期间血压、心率、脉搏氧饱和度,Narcotrend指数(NI)监测麻醉深度,记录意识消失时间、插管时间、插管评分、用药量及不良反应。结果两组患者意识消失时间、插管时间、插管评分及瑞芬太尼用量差异无显著意义。两组患者均很快入睡,插管成功。两组血压、心率诱导后较诱导前降低,插管后无明显增高,均在正常范围,组间比较无显著差异。两组NI值在诱导后及插管期均较诱导前明显降低,SEV组NI值在插管2min后高于PRO组,其余时间点两组差异无显著意义。两组未见明显不良反应,对插管过程无记忆。结论七氟醚及丙泊酚分别复合瑞芬太尼麻醉诱导均可用于无全麻诱导禁忌患者FOB气管插管,两种方法诱导迅速,提供满意的插管条件,且血流动力学平稳。Objective To compare the effect and hemodynamics of sevoflurane （SEV） and propofol （PRO） in combined anesthesia induction with remifentanil for tracheal intubation fibreoptic bronchoscope （FOB）. Methods Twenty-four patients without difficult airway undergoing elective surgery with tracheal intubation general anesthesia were randomly divided into SEV and PRO group. FOB intubation was performed with sevoflurane or propofol administration combined with remifentanil induction. Blood pressure （BP）, heart rate （HR）, SPO2 and Narcotrend index （NI） were monitored to evaluate the anesthetic depth during the induction. The time to loss of consciousness （LOC）, intubation time, intubation score, anesthetic dosage and adverse effects were recorded. Results No significant difference was found between the two groups in the time to LOC, intubation time, intubation score, remifentanil dosage. Intubation was performed successfully in both groups. BP and HR of both groups decreased after the induction and did not increase after the intubation, with variation within the normal range. No significant difference in BP and HR was found between the two groups. NI of both groups decreased after the induction and during intubation. NI of SEV group 2 min after intubation was higher than that of PRO group. There was no significant difference in NI between the two groups at the other time points. No significant adverse effects or recall of the intubation procedure were reported. Coaelusion Anesthesia induction FOB intubation with sevoflurane and propofol, both in combination with remifentanil, can be applied in surgical patients without contraindications to general anesthesia, and both methods can provide fast induction and good intubation condition with stable hemodynamics.

关 键 词：七氟醚 丙泊酚 瑞芬太尼 纤维支气管镜插管 麻醉深度 血流动力学 

分 类 号：R614[医药卫生—麻醉学]