兔异丙酚复合芬太尼颈总动脉注射麻醉的可行性分析  

Study on propofol and fentanyl administrated via common carotid artery in rabbits

作　　者：李志华[1] 李富强[1] 徐贯杰[1] 柳顺锁[1] 

机构地区：[1]河北医科大学第三医院麻醉科,石家庄050051

出　　处：《中华医学杂志》2013年第37期2997-2999,共3页National Medical Journal of China

摘　　要：目的 探讨兔异丙酚复合芬太尼颈总动脉注射麻醉的可行性.方法 成年新西兰白兔60只,数字表随机分为4组：PvFv组、PvFa组、PaFv组、PaFa组,每组15例.建立耳缘静脉和对侧颈总动脉液体通道,采用多通道生理监护仪连续监测平均动脉压（MAP）、心电图、心率、脉搏氧饱和度（SpO2）及脑电波.PvFv组经耳缘静脉恒速输注异丙酚30 mg· kg-1·h-1和芬太尼2 μg· kg-1·h-1;PvFa组和PaFv组分别经耳缘静脉和颈总动脉输注异丙酚和芬太尼;PaFa组经颈总动脉同时输注异丙酚和芬太尼.达脑电静息状态时开始计时,之后调节芬太尼输注速度以维持脑电静息状态持续60 min,观察意识消失时间、达脑电静息时间、苏醒时间,各时点的MAP、心率、呼吸频率（RR）、Sp02,以及药物用量.实验结束时,取颈总动脉置管侧远端行形态学观察.结果 （1）除PaFa组,给药达脑电静息时各组兔均呼吸停止而需手控呼吸.（2）达脑电静息即刻时PaFa组异丙酚（5.56±0.26）和芬太尼（0.91±0.15）低于其他组,PvFa与PvFv组比较差异无统计学意义,但均低于PvFv组（20.92±2.89和3.22±0.36）;PaFa组异丙酚和芬太尼维持剂量低于其余3组（P＜0.05）.（3）PaFa组的给药至意识消失时间（2.87±0.25）、达脑电静息时间（3.92±0.27）及意识恢复时间（5.88±0.52）均明显短于其余3组（P＜0.05）,同时PaFv组及PvFa组又短于PvFv组（P＜0.05）.（4） PvFv组各时点MAP低于其他各组和基础值（P ＜0.05）;PaFa组各时点间MAP、心率差异无统计学意义.（5）各组血管内膜形态无明显改变.结论 兔颈总动脉输注异丙酚复合芬太尼可明显降低用药量,且起效快、苏醒快,对循环、呼吸系统影响轻微,优于耳缘静脉给药方式.Objective To compare the pharmacodynamic differences of common carotid artery administration with ear vein administration of propofol and fentanyl in rabbits.Methods Sixty New Zealand white rabbits were randomly divided into four groups （n =15）：PvFv,PvFa,PaFv and PaFa groups.Propofol 30 mg · kg^-1 · h^-1 and fentanyl 2 μg · kg-1 · h-1 were administrated via the ear vein or the common carotid artery.The outcomes were recorded,including the time of consciousness loss and recovery,to electrocerebral silence,dose of propofol and fentanyl,mean arterial pressure,heart rate,respiration rate and SpO2.Results （1） None of rabbits appeared breathing to be depressed seriously in group PaFa,while respiratory in the other groups were significantly depressed.（2）The dosage of propofol and fentanyl of group PaFa was significantly less than the other groups （P 〈 0.05）.（3） The time of consciousness loss and recovery of group PaFa were shorter than the other three groups.Conclusion Compared to drugs infusion via the ear vein,infusion of propol and fentanyl via the common carotid artery is more advantageous in some aspects,such as rapid anesthesia inducation and recovery,smaller dose,and smaller impact on the hemodynamic and respiratory.

关 键 词：静脉麻醉 颈总动脉 二异丙酚 芬太尼 脑电静息 

分 类 号：R614[医药卫生—麻醉学]