摘要
目的:观察联合应用瑞芬太尼和芬太尼对全麻患者气管插管心血管反应的影响。方法:60例择期手术患者随机分为芬太尼组(F)、瑞芬太尼复合芬太尼组(RF)、瑞芬太尼(R)三组,各20例。分别记录在诱导前5min(T0)、插管即刻(T1)、插管后1min(T2)、插管后3min(T3)、插管后5min(T4)患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR),并观察有无低血压、心动过缓、呛咳、肌强直等并发症。结果:T2、T3时间点,RF组患者的SBP、DBP、MAP均明显低于F组和R组(P<0.05)。T1时间点,R组患者有2例记录到HR<45次/min,需静推阿托品提高心率;1例患者出现SBP<90mm Hg,通过静推麻黄碱纠正。F组有2例患者发生呛咳。结论:全麻诱导时复合小剂量瑞芬太尼和芬太尼,患者气管插管应激反应小,血流动力学指标平稳。
Objective： To observe the effects of remifentanil combined fentanyl on cardiovascular response of endotracheal intubation during general anesthesia. Methods： 60 elective surgery patients were randomly divided into fentanyl （F）group,remifentanil combined fentanyl（RF）group and remifentanil（R）group with 20 patients in each group.The systolic blood pressure（SBP）,diastolic blood pressure（DBP）,mean arterial pressure（MAP）and heart rate（HR）at 5min before intubation（T0）,immediate intubation（T1）,1min after intubation（T2）,3min after intubation（T3）and 5min after intubation（T4）of patients in 3 groups were respectively recorded.The complications,such as bradycardia,cough and muscle rigidity were also observed.Results：At T2 and T3 time point,the SBP,DBP,MAP of patients in RF group were all obviously lower than F group and R group（P〈0.05）.At T1 time point,the HR of 2 patients in R group were lower than 45/min and were treated with intravenous atropine;the SPB of 1 patient was lower than 90mmHg and treated with intravenous ephedrine.2 patients in F group suffered cough.Conclusions：The stress response of endotracheal intubation was light and hemodynamic indexes were stable in patients with low dose of remifentanil combined fentanyl.
作者
顾海军
蒋金娣
GU Hai-jun;JIANG Jin-di(Department of Anesthesiology,the First Affliated Hospital of Nanjing Medical University,Jiangsu Nanjing 210029,China)
出处
《承德医学院学报》
2018年第4期282-285,共4页
Journal of Chengde Medical University
关键词
瑞芬太尼
芬太尼
麻醉诱导
气管插管
心血管反应
Remifentanil
Fentanyl
Anesthesia induction
Endotracheal intubation
Cardiovascular response
