不同剂量瑞芬太尼分别复合丙泊酚对老年高血压患者全麻诱导气管插管时血流动力学的影响  

Effects of different doses of remifentanil combined with propofol on hemodynamics during general anesthesia-induced tracheal intubation in senile hypertensive patients

作　　者：张恩瑜 ZHANG Enyu(Department of Anesthesiology,Laibin People’s Hospital,Guangxi,Laibin 546100,China)

机构地区：[1]广西壮族自治区来宾市人民医院麻醉科,广西来宾546100

出　　处：《中国医药科学》2020年第4期112-115,共4页China Medicine And Pharmacy

摘　　要：目的探讨不同剂量瑞芬太尼分别复合丙泊酚对老年高血压患者全麻诱导气管插管时血流动力学的影响。方法纳入2017年11月~2018年11月本院收治的拟全麻诱导下气管插管并行腹腔镜手术的老年高血压患者82例,采用随机数字表法分为低剂量组41例,高剂量组41例。低剂量组采用1.0μg/kg瑞芬太尼,高剂量组采用2.0μg/kg瑞芬太尼。比较两组患者麻醉效果,插管前、插管后即时和插管5min后血流动力学指标及插管过程中不良反应发生率。结果 (1)两组患者意识消失时间、麻醉维持时间、呼吸恢复时间和睁眼时间比较,差异无统计学意义(P> 0.05);(2)插管后低剂量组患者即时HR、MAP、SBP、DBP均显著高于高剂量组(P <0.05),插管5min后,低剂量组患者HR显著高于高剂量组,MAP、SBP、DBP均显著低于高剂量组(P <0.05);(3)高剂量组呛咳发生率显著低于低剂量组(P <0.05)。结论静脉滴注瑞芬太尼2.0μg/kg联合2.0mg/kg丙泊酚能减少患者麻醉过程中不良反应发生率,有利于维持患者血流动力学稳定。Objective To investigate the effects of different doses of remifentanil combined with propofol on hemodynamics during general anesthesia-induced tracheal intubation in senile hypertensive patients. Methods 82 senile hypertensive patients who underwent general anesthesia-induced tracheal intubation and laparoscopic surgery in our hospital from November 2017 to November 2018 were included. The patients were divided into low dose group(41 cases) and high dose group(41 cases) according to random number table method. 1.0μg/kg remifentanil was used in the low dose group and 2.0μg/kg remifentanil was used in the high dose group. The anesthetic effects, the hemodynamic parameters before intubation, immediately after intubation and 5 minutes after intubation as well as the incidence of adverse reactions during intubation were compared between the two groups. Results(1)There was no significant difference in the time of consciousness disappearance, anesthesia maintenance time, respiratory recovery time and blink time between the two groups(P > 0.05).(2)Immediately after intubation, HR, MAP, SBP and DBP were significantly higher in the low dose group than the high dose group(P < 0.05). After 5 minutes of intubation, the HR in the low dose group was significantly higher than the high dose group, while MAP, SBP and DBP were significantly lower than the high dose group(P < 0.05).(3) The incidence of cough in the high dose group was significantly lower than the low dose group(P < 0.05). Conclusion Intravenous infusion of remifentanil 2.0μg/kg combined with 2.0 mg/kg propofol can reduce the incidence of adverse reactions during anesthesia, which is beneficial to maintain hemodynamic stability.

关 键 词：瑞芬太尼 丙泊酚 老年高血压 气管插管 血流动力学 

分 类 号：R614[医药卫生—麻醉学]