摘要
目的比较不同靶浓度瑞芬太尼对依托咪酯乳剂全麻诱导插管时血流动力学的影响。方法50例择期全麻手术病人按瑞芬太尼的血浆靶浓度随机分为5组(R0、R2、R4、R6、R8),即0、2、4、6、8ng/ml组。依托咪酯血浆靶浓度为0．6μg/ml,与瑞芬太尼同时输注诱导,病人意识消失后静注罗库溴铵辅助插管,记录病人意识消失的时间及意识消失时瑞芬太尼和依托咪酯的血浆靶浓度和效应室靶浓度,监测诱导过程中及插管后血压、心率的变化。结果R0和R2组诱导时间明显长于R4、R6和R8组(P＜0．05),R0和R2组意识消失时的依托咪酯的效应部位计算值高于R4、R6和R8组(P＜0．05)。R2和R4组插管后1min及2min的MAP均高于插管前(P＜0．05)．而R6和R8组插管后1min及2min的MAP与插管前比较差异无显著性(P＞0．05)。结论依托咪酯和瑞芬太尼在全麻诱导时具有协同作用,瑞芬太尼血浆靶浓度6ng/ml复合依托咪酯血浆靶浓度0．6μg/ml诱导能较好地控制插管时的血流动力学反应。
Objective： To compare the effects of remifentanil in various target plasma concentrations on hemodynamic response to tracheal intubation induced with etomidate. Methods ： Fifty ASA Ⅰ - Ⅱ patients at the ages of over 65 undergone elective surgery under general anesthesia were enrolled in this study. The patients were unpremedieated. Anesthesia was induced with remifentanil and etomidate which were both given by TCI simultaneously. The patients were randomized to receive remifentanil at a fixed target plasma concentration of 0,2,4,6 or 8ng/ml （ group R0, R2, R4, R6, R8 ）. TCI etomidate was at a target plasma concentration of 0.6ug/ml. Trachea was intubated together with intravenous rocuronium when the consciousness of patients was lost. The time was recorded when the consciousness of patients was lost and the changes of BP and HR were monitored in the induced process and after intubation. Results： Induction time was significantly longer in group R0 and R2 than that in group R4, R6 and R8 （ P 〈 0. 05 ）. MAP increased significantly for 2 minutes after intubation in group R2 and R4,but MAP did not change in group R6 and R8 after intubation. Conclusion： Remifentanil potentiates etomidate when given by TCI simultaneously for induction of anesthesia. The target plasma etomidate concentration of 0. 6 ug/ml in the presence of plasma remifentanil concentration of 6 ng/ml can effectively attenuate the intubation response.
出处
《泰山医学院学报》
CAS
2006年第3期222-224,共3页
Journal of Taishan Medical College
