瑞芬太尼与芬太尼复合依托咪酯用于麻醉诱导的比较

目的观察依托咪酯复合瑞芬太尼用于麻醉诱导的临床疗效。方法 92例全麻行气管插管的患者随机分为观察组和对照组各46例,全麻诱导采用静脉给予咪唑安定（0.05 mg.kg-1）、依托咪酯（0.3 mg.kg-1）和罗库溴铵（0.6 mg.kg-1）,观察组加入瑞芬太尼（2.0 ug.kg-1）,对照组加入芬太尼（2.5 ug.kg-1）,观察2组给药前、插管前后呼吸和循环的变化。结果对照组插管前1 min心率明显升高（P〈0.05）;观察组诱导过程及插管后1min患者的血压、心率无明显变化（P〉0.05）;气管插管后1 min,观察组的SBP、DBP、HR明显低于对照组（P〈0.05）。麻醉诱导后对照组SPO2显著下降（P〈0.05）,观察组变化不明显（P〉0.05）;2组BIS在给药后显著下降（P〈0.05）,组间比较无明显差别（P〉0.05）。结论依托咪酯复合瑞芬太尼用于全麻诱导气管插管时血流动力学稳定,且能有效抑制插管时心血管应激反应,值得临床推广。

Comparative Study on Anesthesia Induction of Etomidate Combined with Remifentanil or Fentanyl

Objective To observe the clinical efficacy of anesthesia induction by etomidate combined with remifentanil.Methods 92 cases of anesthesia and tracheal intubation were randomly divided into observation group and control group(n=46).Midazolam(0.05 mg·kg-1),etomidate(0.3 mg·kg-1) and rocuronium bromide(0.6 mg·kg-1) were used for anesthesia induction,meanwhile,remifentanil(2.0 μg·kg-1) was added to observation group and fentanyl(2.5 μg·kg-1) was added to control group.The changing of respiratory and circulatory were observed.Results Heart rate of control group on the timepoint of 1 min before intubation was significantly increased(P<0.05).Blood pressure and heart rate of observation group in the process of induction and on the timepoint of 1 min after intubation didn’t change obviously,but its SBP,DBP and HR on the timepoint of 1 min after intubation were significantly lower than those in control group(P<0.05).SPO2 of control group after anesthesia induction decreased significantly(P<0.05),but that of conversation group didn’t change obviously.BIS of two groups decreased significantly after administration,there were no significant differences between them.Conclusion Anesthesia induction of remifentanil combined with etomidate can maintain the hemodynamic stability and can inhibit cardiovascular response,deserve the clinical expansion.