瑞芬太尼与异丙酚联合用药对气管插管血流动力学的影响

目的　 研究单次静注瑞芬太尼与异丙酚对全身麻醉快速诱导窥喉和气管插管的血流动力学的影响及合适的剂量。 方法 　 35例ASAⅠ—Ⅱ级的全麻患者 ,随机分为 3组 :Ⅰ组 10例 ,Ⅱ组 12例 ,Ⅲ组 13例 ,在静注维库溴铵 0 1mg/kg ,异丙酚 1 5mg/kg后 ,3组分别予生理盐水或瑞芬太尼 1,2 μg/kg(均以生理盐水稀释为 2 0ml,输入时间大于 30s) ,6 0s后插管。连续监测插管前后血流动力学变化。 结果 　Ⅰ组患者插管后各项参数明显升高 ,持续到插管后 5min ,与用药前比较 ,组内差异有显著性 (P <0 0 5 ) ;与Ⅱ、Ⅲ组相比 ,组间差异也有显著性 (P<0 0 5 )。Ⅱ组患者插管后各项参数变化与用药前比较无统计学差异。Ⅲ组患者插管前和插管后血压明显下降 ,与用药前比较有统计学差异 (P <0 0 5 )。 结论 　瑞芬太尼 1 0 μg/kg通常可较好地抑制窥喉和气管插管时的高血流动力学

Effect of remifentanil and propofol on the haemodynamic response to tracheal intubation

Objective To study effect of bolus dose remifentanil and propofol on the haemodynamic response to laryngoscopy and tracheal intubation during rapid sequence induction of anaesthesia and suitable dose.Methods 35 ASA Ⅰ-Ⅱ patients were divided randomly into three groups: iv normal saline(groupⅠ,n=10),remifentanil 1.0 μg/kg(groupⅡ,n=12),remifentanil 2.0 μg/kg(groupⅢ,n=13).Anaesthesia was induced with vecuronium 0.1 mg/kg and propofol 1.5 mg/kg followed by saline(placebo) or remifentanil 1.0 or 2.0 μg/kg given as a bolus over 30s(dilute to 20ml with saline).Laryngoscopy and tracheal intubation were performed 60s later.Changes of haemodynamic parameters were recorded continuously.Results The haemodynamic parameters of groupⅠincreased significantly and lasted 5 min after post-intubation,compared with those of pre-induction or groupⅡ,groupⅢ(P<0.05).No changes of haemodynamic parameters were found in groupⅡ,compared with those of pre-induction.The haemodynamic parameters of group Ⅲ decreased significantly in pre-intubation or post-intubation,compared with those of pre-induction (P<0.05).Conclusion Remifentanil 1.0 μg/kg could depress the haemodynamic response to laryngoscopy and tracheal intubation effectively.