阿芬太尼静脉全麻对呼吸的影响

Respiratory effect of alfentanil(AF)under intravenous general anesthesia

选择在全麻气管插管下行各种择期手术的成年病人 ４０例， ＡＳＡⅠ－Ⅱ 级。第一组为临床组（ｎ＝２０），静脉泵入阿芬太巳，诱导剂量为４０μｇ／ｋｇ，维持剂量为每分钟１μｇ／ｋｇ，第二组为对照组（ｎ＝２０），静脉泵人芬大尼，诱导剂量为４μｇ／ｋｇ，维持剂量为每分钟０．１μｇ／ｋｇ，维持期间皆吸入０．５％～１．５％安氟醚和氧气，酌情使用维库溴铵维持肌肉松弛、观察两组在人室、给药后１～５分钟和拔管０～１０分钟时的血氧饱和度、呼吸频率、潮气量的变化，实验结果发现阿芬太尼和芬太尼都具有呼吸抑制作用，且阿芬太尼的呼吸抑制作用更强。阿芬太尼还可产生迟发性呼吸抑制。因此，我们建议在临床使用阿芬太尼时保证供氧，并常规监测ＳPＯ２，术后２～４小时留恢复室观察。

Fourly ASA Ⅰ - Ⅱ adult patients underwent various elective surgery with endotracheal intubation under the intravenous general anesthesia were randomly divided into two groups. The experimental group Ⅰ(n = 20) infused with an initial dose of AF 40μg/kg intravenously within 5 min and maintained with 1μg .kg-1 /min,while the control group Ⅱ (n = 20) received fentanyl (F) 4μg/kg and 0. 1μg. kg-1/min respectively. These patients inhaled 0' 5 % ~ 1. 5 % enflurane in oxygen and vecuronium was administered to keep muscular relaxation. The SpO2, RR, VT were observed before operation,after infusion of AF or F every minute for 5 minutes and 0, l, 3, 5, 10 minutes after extubation. The results showed that both AF and F had respirstory inhibition,but the effect of AF was more pronounce than F. Dne to the possibility of delayed respiratory inhibition,it is suggested that the respiration should be monitored in the recovery room for 2-4 hours.