【摘要】 目的:观察不同剂量瑞芬太尼对气管插管所致的心血管反应的预防作用。方法:60例ASAⅠ级择期全麻的患者,随机分为A,B,C 3个剂量组,每组20例。麻醉诱导采用静注咪达唑仑0.1mg/kg,丙泊酚2 mg/kg,维库溴胺0.1 mg/kg,A组予瑞芬太尼1μg/kg,B组予瑞芬太尼2μg/kg,C组予瑞芬太尼3μg/kg,3 min后行气管插管。观察三组患者诱导前5min,诱导后3 min,气管插管1,2,3,5min的血压(MAP)和心率(HR)变化。结果:诱导后三组的MAP和HR均显著降低(P<0.05)。插管后A组四个时间点的MAP和HR均显著升高(P<0.05);B组和C组插管后四个时间点的MAP和HR均显著降低(P<0.05)。B组和C组诱导后和插管后的MAP和HR的降低比A组更显著(P<0.05)。C组有4例患者在诱导后MAP下降低于60 mmHg。结论:瑞芬太尼2μg/kg能有效预防全麻诱导气管插管所致的心血管反应。更多还原

【Abstract】 Objective:To observe the efficacy and safety of remifentanil in the management of cardiovascular responses induced by tracheal intubation.Method:Sixty voluntary patients,ASAⅠ,underwent general anesthesia for elective surgery,were enrolled and randomly divided into three groups,20 cases in each.Each patient was anesthetized with midazolam 0.1 mg/kg,propofol 2mg/kg and vecuronium 0.1mg/kg by intravenous route in all groups,and then given with remifentanil by intravenous infusion at dose of 1μg/kg(n=20),2μg/kg(n=20),3μg/k(n=20)g for group A,B,C respectively.The trachea was intubated 3 minutes after induction.Mean arterial pressure(MAP) and heart rate(HR) were measured at the time 5 minutes pre-anesthesia induction,3minutes after induction,and 1,2,3,5 minutes after tracheal intubation.Result:The patients showed significantly decrease of MAP and HR after induction(P<0.05).The patients at 1μg/kg remifentanil showed significantly increase of MAP and HR after intubation(P < 0.05) MAP and HR.Of the patients at dose of 2μg/kg and 3μg/kg remifentanil decreased significantly at 1,2,3,5 minutes after intubation(P < 0.05).Both MAP and HR after induction and intubation were significantly lower in the patients at 2μg/kg and 3μg/kg remifentanil than that of 1μg/kg remifentanil(P < 0.05).MAP four patients at 3μg/kg remifentanil experienced a deep decrease of MAP less than 60 mmHg.Conclusion:Remifentanil at dose of 2μg/kg is effective and safe to manage cardiovascular responses due to tracheal intubation.更多还原