靶控输注瑞芬太尼对心电图的影响  

The influence of target-controlled infusion remifentanil on electrocardiogram

作　　者：徐桂萍[1] 刘小兵[1] 曹振刚[1] 

机构地区：[1]新疆维吾尔自治区人民医院麻醉科,乌鲁木齐市830001

出　　处：《临床麻醉学杂志》2013年第4期342-343,共2页Journal of Clinical Anesthesiology

基　　金：新疆维吾尔自治区人民医院科研基金资助项目(20110120)

摘　　要：目的观察瑞芬太尼对心电图(ECG)PR间期、QTc间期、QRS时限及HR的影响,探讨瑞芬太尼对心脏传导系统的抑制位点。方法择期行腹腔镜胆囊切除术患者30例,年龄20～55岁。进入手术室后给予咪达唑仑0.08mg/kg镇静,意识消失5min后记录ECG1。然后靶控输注瑞芬太尼,效应室靶浓度5ng/ml,待血浆浓度与效应室靶浓度达到平衡后记录ECG2。分析比较两个时间点ECG的PR间期、QTc间期、QRS时限及HR。结果与ECG1比较,ECG2的QTc间期、QRS时限显著延长(P<0.01),HR显著减慢(P<0.01),而PR间期差异无统计学意义。结论瑞芬太尼可能通过干扰房室结至心室肌细胞间传导系统对心脏产生抑制作用。Objective To observe the influence of remifentanil on PR interphase,QTc interval, ORS complex interval and heart rate of electrocardiogram, and to explore the possible action site of remifentanil to cardiac conduction system- Methods Thirty patients aged 20-55 years, undergoing laparoscopic cholecystectomy were enrolled in this study. 0. 08 mg/kg midazolam was intravenously infused and ECG1 was recorded 5 minutes after loss of consciousness. Remifentanil was infused in TCI mode and the effect-site concentration was set at 5 ng/ml. ECG2 was recorded after the target effect-site concentration balanced with plasma concentration. PR interphase, QTc interval, QRS complex interval and heart rate of ECG between the two points were compared. Results QTc interval and QRS complex interval prolonged and heart rate decreased significantly without influence to PR interphase after remifentanil infusion（P〈0. 01）. Conclusion Remifentanil has an inhibit effect on His bundle and/or ventricular conduction system.

关 键 词：瑞芬太尼 心脏传导系统 PR间期 QTC间期 QRS时限 

分 类 号：R614[医药卫生—麻醉学]