不同剂量地佐辛预防气管插管心血管应激反应的对比

目的研究地佐辛用于全麻诱导气管插管时对血流动力学的影响，评价其用于麻醉诱导的安全、有效及可行性。方法选择择期行腹腔镜胆囊切除术患者60例，ASAI～Ⅱ级，将其随机分为三组：I组为对照组（舒芬太尼组），给予静脉注射咪达唑仑0．01mg,／kg，舒芬太尼0．2μg/kg，罗库溴铵0．6mg／kg行全麻诱导；Ⅱ组应用咪达唑仑0．01mg／kg，地佐辛0．1mg／kg，罗库溴铵0．6mg／kg；m组应用咪达唑仑0．01mg／kg，地佐辛0．2mg／kg，罗库溴铷．6mg／kg；三组均行微量泵输注异丙酚，BIS值降至60以下时行气管插管。观察诱导前、气管插管前、插管时及插管后1min、3min及5min6个时点的血流动力学参数值变化，并记录各组全麻诱导气管插管时应用异丙酚的总量。结果①三组患者的一般情况无明显差异；②与I组相比，Ⅱ组在插管时及插管后1min、3min及5min的平均动脉压和心率明显高于I组，Ⅲ组在各时点平均动脉压和心率与I组相比无明显差异；③异，丙酚在诱导气管插管时的总用量，I组为（88±11）mg，Ⅱ组为（124±17）mg，Ⅲ组为（91±13）mg，Ⅱ组异丙酚用量显著大于I组和Ⅲ组，I组和Ⅲ组组间比较差异无统计学意义。结论地佐辛可用于全麻诱导气管插管，0．2mg／蝇能维持全麻气管插管诱导期间血流动力学的稳定，达到有效的麻醉深度，抑制气管插管所造成的心血管应激反应。

Different dosage of dezocine to prevent cardiovascular stress reaction due to endotracheal intubation

Objective To study the effects of dezocine which used to induction of general anesthesia to prevent cardiovascul＇ar stress reaction due to endotracheal intubation, and evaluate its safety, effectiveness and feasibility used for the induction of general anesthesia. Methods Selective laparoscopic choleeystectomy patients 60 cases, ASA I - Ⅱ were chosen. They were randomly divided into three groups： group I was control group （sufentanil group ）, given intravenous injection midazolam 0. 01 mg/kg, sufentanil 0. 2 μg/kg, rocuronium bromide 0.6 mg/kg to induction of general anesthesia; group Ⅱ was given intravenous injection midazolam 0.01 mg/kg, dezocine 0. 1 mg/kg, rocuronium bromide 0.6 mg/kg; group m was given intravenous injection midazolam 0.01 mg/kg, dezocine 0. 2 mg/kg, rocuronium bromide 0. 6 mg/kg. Three groups were performed to infuse propofol by micro pump; BIS value dropped to below 60 was to execute endotracheal intubation. Hemodynamie parameters change which before induction of general anesthesia, before eudotracheal intubation, during and after the endotracheal intubation 1 min, 3 min and 5 min were observed, and the amount of propofol used to in- duction of general anesthesia endotracheal intubation were recorded. Results ①The general situation of three groups of patients had no obvious difference ; ②The MAP and HR of group Ⅱduring intubation and intubation 1 min, 3 min, 5 rain were significantly higher than those of group I , the MAP and HR of group Ⅲ compared with group I had no obvious difference ; ③The total amount of propofol in induction of general anesthesia were （ 88 ± 11 ） mg in group I, （ 124 ± 17 ） mg in group Ⅱ, （91 ± 13 ） mg in group m. The propofol dosage of group Ⅱ was significantly higher than group I and group Ⅲ, the group comparison of propofol dosage between group I and group Ⅲ has no statistical significance. Conclusions Dezocine can be used for induction of general anesthesia endotracheal intubation, 0.2 mg/kg dezocine can maintain hemodynamic stability during induction of general anesthesia endotracheal intubation, a-chieve effective depth of anesthesia, and restrain cardiovascular stress due to reaction endotracheal intubation.