摘要
目的探讨不同剂量雷米芬太尼对全身麻醉(简称全麻)诱导期血流动力学和血浆皮质醇的影响。方法选取医院手术全麻患者56例,采用随机数字表法分为4组,各14例。所有患者均常规予咪唑安定、丙泊酚和罗库溴铵。A组加用芬太尼2μg/kg,B组、C组、D组分别加用雷米芬太尼0.5,1.0,1.25μg/kg。结果 4组患者用药后收缩压、舒张压及心率均有所下降,C组及D组各时间段指标较A组及B组下降更明显;气管插管后,4组患者收缩压、舒张压及心率均有所上升,A组及B组上升较明显(P<0.05)。插管后4 min,4组患者皮质醇均有所上升,A组及B组上升明显;插管后6 min,皮质醇均有所下降,C组及D组下降较明显(P<0.05)。C组及D组低血压发生率及呼吸抑制发生率明显高于A组及B组(P<0.05)。结论 0.5~1.0μg/kg雷米芬太尼用于患者手术麻醉诱导,中枢抑制良好,能减少药物过度抑制带来的损伤。
Objective To investigate the effects of different doses of remifentanil on hemodynamics and plasma cortisol of patients dur-ing general anesthesia induction period. Methods Totally 56 patients underwent general anesthesia surgery were selected and randomly divided into four groups, 14 cases in each group. All patients received the conventional treatment of midazolam, propofol and rocuronium, on this basis, Group A received fentanyl 2 μg/kg, Group B, Group C and Group D received remifentanil 0. 5, 1. 0, 1. 25 μg/kg, respectively. Results After treatment, the systolic blood pressure, diastolic blood pressure and heart rate in the four groups were decreased, the indexes in group C and group D were decreased more obviously than those in group A and group B （ P 〈 0. 05 ） , after tracheal intubation, the systolic blood pressure, diastolic blood pressure and heart rate in the four groups were increased, the indexes in group A and group B were increased more obviously （ P 〈 0. 05 ） . 4 min after tracheal intubation, cortisol in the four groups were increased, and group A and group B were increased more obviously, 6 min after tracheal intubation, cortisol in the four groups were decreased, and group C and group D were decreased more obviously （ P 〈 0. 05 ） . The incidence rates of hypotension and respiratory depression in group C and group D were significantly higher than those in group A and group B （ P 〈 0. 05 ） . Conclusion 0. 5-1. 0 μg/kg remifentanil used for patients during general anesthesia induction period has good central inhibition, it can reduce the damage caused by excessive drug inhibition.
出处
《中国药业》
CAS
2017年第19期53-55,共3页
China Pharmaceuticals
