地佐辛与芬太尼对健忘镇痛慢诱导麻醉气管插管应激反应的影响研究  

Study on effects of dezocine and fentanyl on intubation stress response during slow induction of anesthesia

作　　者：李国利[1] 王暐[1] 刘薇[1] 滕金亮[1] 李福龙[1] 

机构地区：[1]河北北方学院附属第一医院麻醉科,河北张家口075000

出　　处：《重庆医学》2015年第13期1796-1798,共3页Chongqing medicine

基　　金：河北省张家口市2013年度科学技术研究与发展计划项目(1321096D)

摘　　要：目的对比观察地佐辛与芬太尼对健忘镇痛慢诱导麻醉气管插管应激反应的影响。方法选择ASAⅠ或Ⅱ级、择期全身麻醉腹部手术患者40例,分为芬太尼组(F组,n=20)、地佐辛组(D组,n=20)。两组患者均静脉注射咪达唑仑0.03mg/kg,随后地佐辛组静脉注射地佐辛0.2mg/kg,芬太尼组静脉注射芬太尼2μg/kg。给药5min后环甲膜穿刺注入1%丁卡因注射液2mL行喉部表面麻醉,喉麻3min时在直视下行气管内插管。记录患者入室后,静脉注药前(T0),静脉注药后3min(T1),5min(T2),环甲膜穿刺时(T3),穿刺后3min(T4),气管插管即刻(T5),插管后5min(T6)各时刻的心率(HR)、收缩压(SBP)、舒张压(DBP)、氧分压(SpO2)、BIS值;并记录各时刻的镇静程度。结果两种药物都能有效地抑制穿刺及插管时血压、心率等应激反应,但地佐辛组在慢诱导麻醉插管过程中对心血管系统的影响明显优于芬太尼组。结论 0.2mg/kg地佐辛用于健忘镇痛慢诱导麻醉抑制气管插管应激反应优于2μg/kg芬太尼,且不良反应发生率低。Objective To observe the effects of dezocine and fentanyl on the intubation stress response in slow induction of anesthesia. Methods Forty ASA Ⅰ - Ⅱ patients were selected and divided into two groups. Anesthesia was induced with midazolam 0.03 mg/kg in both groups,and dezocine 0.2 mg/kg was given in the dezocine group or fentanyl 2μg/kg in the fentanyl group. Five rain later, 2 mL of 1% decicaine was administered by cricothyroid membrane puncture to facilitate the intubation. SpO2, circulatory indexes （ HR, SBP, DBP, BIS） and＇ sedation level were measured before intravenous inj ection（T0 ）, at 3 min（T1 ）, 5 rain（T2 ） after injection of drugs,at cricothyroid membrane puncture （T3）, at 3 min after cricothyroid membrane puncture（T4 ）, immediately after tracheal intubation（T5 ） and at 5 rain after tracheal intubation（T6）. Results Both dezocine and fentanyl could effectively inhibit the stress responses of blood pressure and hear rate in the puncture and tracheal intubation, but the dezocine group was significantly better than the fentanyl group in the effects on cardiovascular system during the tracheal intubation process in slow induction of an- esthesia. Conclusion Dezocine 0.2mg/kg can effectively inhibit the stress responses in tracheal intubation with a low incidence of adverse reactions in the slow induction of anesthesia,which is superior to fentanyl 2 μg/kg,moreover has low occurrence rate of ad- verse reactions.

关 键 词：麻醉和镇痛 插管法 气管内 地佐辛 芬太尼 

分 类 号：R614[医药卫生—麻醉学]