瑞芬太尼对七氟醚诱导过程中QTc的影响  

The effects of remifentanil on QTc during laryngeal mask airway placement under sevoflurane induction

作　　者：胡健[1] 顾尔伟[1] 张健[1] 卢转娣[2] 

机构地区：[1]安徽医科大学第一附属医院麻醉科,合肥市230032 [2]合肥市第二人民医院心电功能科

出　　处：《临床麻醉学杂志》2012年第7期643-645,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨七氟醚诱导过程中瑞芬太尼快速输注是否延长校正的QT间期(QTc)。方法择期全麻行妇科手术的患者60例,ASAⅠ或Ⅱ级。双盲随机抽样法将患者均分为瑞芬太尼组(RF组)和对照组(NS组)。采用脑电双频指数(BIS)监测,5%七氟醚吸入诱导。BIS值60～65时,30s内静脉注射0.2μg/kg瑞芬太尼(RF组)或等容量生理盐水(NS组)。BIS≤60时,给予0.05mg/kg维库溴铵,当BIS在45～50时行喉罩插管。分别记录诱导前(基础值)、喉罩插入后1、3min的12导联ECG、MAP和HR。采用Bazett公式计算QTc。结果与NS组比较,喉罩插入后1minRF组QTc缩短(P<0.05);HR明显减慢、MAP降低(P<0.05)。而插入后3min两组间QTc差异无统计学意义。结论七氟醚诱导联合喉罩插入时,瑞芬太尼快速输注可有效减轻QTc延长。Objective To examine the effect of single bolus of remifentanil on QTc during laryngeal mask airway （LMA） placement under sevoflurane induction. Methods Sixty female ASA Ⅰ or Ⅱ patients undergoing gynecological surgery were allocated into group remifentanil（group RF,n= 30） or group placebo （group NS,n=30）. All the patients received bispectral index （BIS） monitoring and inhalational induction with 5% sevoflurane. Remifentanil（group RF） or normal saline （group NS） was infused over a 30 second period when BIS value in the range of 60-65, and laryngeal mask was inserted when BIS value dropped to 45 50. 12-lead ECG, MAP and HR were recorded at baseline, 1 and 3 rain after LMA insertion. QTe was calculated by Bazett＇s formula. Results The QTc interval was significantly prolonged in group NS as compared with group RF at 1 rain after LMA insertion. However, there was no significant difference in QTc at 3 min after LMA insertion between the two groups. Conclusion Single bolus of remifentanil can prevent QTc prolonging during LMA placement in sevoflurane induction.

关 键 词：校正的QT间期 喉罩 瑞芬太尼 七氟醚 脑电双频指数 

分 类 号：R614[医药卫生—麻醉学]