雷米芬太尼和芬太尼分别联合丙泊酚诱导麻醉对气管插管患者血流动力学的影响

目的: 观察雷米芬太尼和芬太尼分别联合丙泊酚诱导麻醉对气管插管前后患者血流动力学的影响。方法: 选择40例择期手术患者,随机均分为雷米芬太尼组和芬太尼组。采用丙泊酚2 mg/kg、罗库溴胺0.6 mg/kg诱导麻醉,雷米芬太尼组采用雷米芬太尼2μg/kg,芬太尼组采用芬太尼3μg/kg,观察诱导前(T₁)、插管前1 min (T₂)和插管后2 min (T₃)的收缩压(SBP)、舒张压(DBP)和心率(HR)的变化。结果: 两组患者诱导后SBP、DBP、HR较诱导前均明显降低(P<0.01),插管后雷米芬太尼组SBP、DBP、HR基本接近诱导前值(P>0.05),芬太尼组SBP、DBP均较诱导前明显升高(P<0.01和P<0.05),而心率无明显差异(P>0.05)。两组间SBP、DBP和HR差异均有统计学意义(P<0.01)。结论: 雷米芬太尼、芬太尼均能抑制气管插管患者的血流动力学变化,但雷米芬太尼作用明显。

Influence of remifentanil,fentanyl combined with propofol in induction of anaesthesia on hemodynamic changes during intubation

Objective: To compare the influences of remifentanil,fentanil combined with propofoil on the hemodynamic changes during intubation.Methods: Forty operation patients under general anesthesia were randomly divided into two groups:group R(group remifentanil) and group F(group fentanil).Anesthesia was induced with intravenous propofol 2 mg/kg and rocuronium 0.6 mg/kg.Remifentani 2 μg/kg was used in group R and fentanyl 3 μg/kg in Group F.The systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were measured before anesthesia induction(T₁),1 minute after induction(T₂)and 2 minutes after endotracheal intubation(T₃).Results: Compared with the baseline,blood pressure and HR decreased significantly after induction in the two groups(P<0.01);after endotracheal intubation,the SBP,DBP and HR in group R returned to the baseline(P>0.05).SBP and DBP in group F increased significantly after endotracheal intubation(P<0.05),but HR showed no difference(P>0.05).SBP,DBP and HR in the two groups differed significantly(P<0.01).Conclusions: Remifentanil and fentanyl can inhibit cardiovascular response during intubation,and remifentani is more effective than fentanyl.