阿片类药物用于抑制气管内插管副反应时合理给药时机优于药物种类和剂量的选择

已经证明芬太尼能很好地抑制气管插管的心血管副反应。舒芬太尼是芬太尼的N-4噻吩基衍生物,与阿片受体的亲和力较芬太尼强,镇痛作用是芬太尼的10倍,而且作用持续时间也更长。瑞芬太尼是一种新型μ阿片受体激动剂,具有起效迅速、作用时间短、镇痛作用与芬太尼近似、恢复迅速、无

Reasonable orders of administration better than the choice of kinds or dosages of opioids used to alleviate cardiovascular responses to tracheal intubation

Objective To evaluate the best dosages,orders of administration and effects of opioids on the cardiovascular responses to tracheal intubation.Methods 135 patients undergoing elective surgery and requiring general anesthesia were randomized to 9 groups,15 patients in each group.We designed the orders of the induction drugs in each group to make all the drugs would reach the peak concentration at the time of intubation.MAP,HR,CI and SVRI were recorded.Results MAP decreased in all the groups except R1 after induction of anesthesia(P<0.05) and increased after intubation,but not exceed the basic values,and MAPs in R2 and R3 were still lower than baseline(P<0.05).There wasn't obvious changes in HR in all the groups except S2 after induction;after intubation,HR in all the groups increased slightly,but only HR in S2 exceed baseline significantly(P< 0.05).CI in all the groups decreased slightly after anesthesia induction.SVRI in all the groups decreased slightly after anesthesia induction,but only changes in F2 had statistical sense;at 1min after intubation,SVRIs weren't kigher than the baseline.Conclusion Opioids combined with propofol are used in the induction of anesthesia,on the effect of restraining the cardiovascular responses,it is more important to choose the reasonable orders of administration of the anesthetics than the kinds or dosages of opoids.