【摘要】 目的比较布托啡诺与芬太尼抑制全麻气管插管应激反应的临床效果。方法拟在全麻下行择期上腹部手术患者60例,ASAⅠ或Ⅱ级,随机均分为两组。全麻诱导前5min,布托啡诺组静脉注射布托啡诺40μg/kg,芬太尼组静脉注射芬太尼4μg/kg。全麻诱导时,两组均靶控输注效应室浓度为4μg/ml的丙泊酚,患者意识消失后给予维库溴铵行气管插管。记录全麻诱导前7min(T0)、气管插管前即刻(T1)、插管后1min(T2)、3min(T3)和10min(T4)各时点MAP、HR,并于T0、T2、T4时采集桡动脉血,测定血浆肾上腺素(E)和去甲肾上腺素(NE)浓度。结果芬太尼组T1、T4时HR比T0时明显减慢(P<0.05),且芬太尼组T1时HR明显慢于布托啡诺组(P<0.05);两组气管插管前后及两组间比较,MAP、血浆E和NE浓度差异无统计学意义。结论布托啡诺和芬太尼均可以有效地抑制全麻气管插管应激反应,与芬太尼相比,布托啡诺对心率的影响较小。更多还原

【Abstract】 Objective To compare the effects of butorphanol and fentanyl on tracheal intubation stress response.Methods Sixty ASA class Ⅰ or Ⅱ patients scheduled for upper abdominal surgery undergoing general anesthesia were randomly divided into two groups with 30 cases each.Five min before induction,the patients in butorphanol group were given Ⅳ butorphanol 40 μg/kg,and those in fentanyl group were given Ⅳ fentanyl 4 μg/kg.During induction of anesthesia,they were all given propofol target controlled infusion(4 μg/ml),and vecuronium was given to faciliate tracheal intubation.MAP,HR at the time points of 7 min before induction(T0),immediately before(T1),1 min(T2),3 min(T3) and 10 min(T4) after intubation were recorded.Radial artery blood was collected to test the concentration of epinephrine(E) and norepinephrine(NE) at T0,T2 and T4.Results HR of fentanyl group at T1 and T4 was obviously lower than that at T0(P<0.05),HR of fentanyl group at T1 was obviously lower than that of butorphanol group(P<0.05).Before and after intubation there was no significant difference in MAP,E and NE between the two groups.Conclusion Butorphanol can effectively inhibit tracheal intubation stress response with less effect on HR than fentanyl.更多还原