氨茶碱预防瑞芬太尼负性变频作用的效果  

Efficacy of aminophylline for prevention of negative chronotropic effect of remifentanil

作　　者：刘艳秋[1] 高鸿[1] 杨扬[1] 吴海星[1] 

机构地区：[1]贵阳医学院附属医院麻醉科,550004

出　　处：《中华麻醉学杂志》2014年第4期446-448,共3页Chinese Journal of Anesthesiology

摘　　要：目的 评价氨茶碱预防瑞芬太尼负性变频作用的效果.方法 择期全麻患者40例,性别不限,年龄20 ～ 55岁,体重指数18 ～ 25 kg/m2,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为对照组（C组）和氨茶碱预先给药组（AP组）,每组20例.C组麻醉诱导前30 min静脉输注生理盐水20 ml,AP组静脉输注氨茶碱3 mg/kg,随后静脉注射咪达唑仑0.1 mg/kg,患者入睡后缓慢静脉注射瑞芬太尼2μg/kg,行人工辅助通气,7 min后静脉注射维库溴铵0.1 mg/kg、芬太尼3μg/kg和依托咪酯0.3 mg/kg,气管插管后行机械通气.于麻醉诱导前（T0）、入睡（T1）、瑞芬太尼注射完后即刻（T2）、1、3、5和7 min（T3-6）时记录HR和MAP;记录T0、T1和T2时低频功率（LF）和高频功率（HF）,计算LF/HF比值.结果 与T0时比较,两组T2-6时MAP和HR降低,AP组T1时LF和HF降低,LF/HF比值升高（P＜0.05）;与C组比较,AP组HR和LF/HF比值升高,T1时LF和HF降低（P＜0.05）.结论 氨茶碱预防瑞芬太尼对患者心脏的负性变频作用的效果较好.Objective To evaluate the efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil.Methods Forty patients undergoing general anesthesia,aged 20-55 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or 1Ⅱ,were randomly divided into control group （group C） and aminophylline group （group AP）,with 20 patients in each group.At 30 min before induction of anesthesia,normal saline 20 ml was infused intravenously in group C,and aminophylline 3 mg/kg was infused intravenously in group AP.Midazolam 0.1 mg/kg was then injected intravenously.Remifentanil 2 μg/kg was injected intravenously after the patients fell asleep and then artificial ventilation was performed.Vecuronium 0.1 mg/kg,fentanyl 3 μg/kg,and etomidate 0.3 mg/kg were injected intravenously 7 min later.The patients were then endotracheally intubated and mechanically ventilated.HR and MAP were recorded before induction of anesthesia （T0）,after falling asleep （T1）,and at 0,1,3,5 and 7 min （T2-6） after the end of remifentanil injection.Low frequency （LF） and high frequency （HF） were recorded at T0,T1 and T2,and the ratio of LF/HF was calculated.Results Compared with the baseline value at T0,MAP and HR were significantly decreased at T2-6 in the two groups,and LF and HF were decreased at T1,and LF/HF ratio was increased at T1 in group AP.HR and LF/HF ratio were significantly higher,and LF and HF were lower at T1 in group AP than in group C.Conclusion The efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil on the hearts of patients is good.

关 键 词：氨茶碱 哌啶类 心动过缓 

分 类 号：R614[医药卫生—麻醉学]