瑞芬太尼复合异丙酚麻醉诱导对气管插管条件及血流动力学的影响

Effect of remifentanil combined with propofol anesthetic induction on intubating conditions and hemodynamics

目的对比不使用肌松剂的情况下,瑞芬太尼或芬太尼复合异丙酚麻醉诱导后对气管插管条件及血流动力学的影响。方法60名病人分为2组,诱导后2min行气管插管术。分别记录诱导前、诱导后1min及插管后2min的平均动脉压(MAP)和心率(HR)。插管条件由操作者给予评分。结果两组插管成功率均为100%。瑞芬太尼组插管条件满意率80%,芬太尼73%。两组诱导后MAP和HR值较基础值均下降(P<0.05)。插管后两组间的MAP值差异有统计学意义(P<0.05)。结论瑞芬太尼复合异丙酚麻醉诱导取得了同芬太尼复合异丙酚麻醉诱导一样良好的插管条件,在抑制插管引起的心血管反应方面瑞芬太尼组优于芬太尼组。

Objective To compare and assess the intubating conditions and hemodynamic changes after anesthetic induction using remifentanil or fentanyl combined with propofol. Methods sixty patients were divided into 2 groups. After anesthetic induction 2 minutes, tracheal intubation was performed. The mean arterial pressure （MAP） and heart rate （HR） were determined before anesthetic induction, 1 minute and 2 minutes after intubation respectively. Tracheal intubating conditions were scored by operator. Results Successful rate of intubation was 100% in both groups. Satisfactory rate of intubating conditions were 80% and 73% in remifentanil group and fentanyl group respectively. The MAP and HR were lower than that baseline after induction （P〈0.05）. After intubation, there was significant differene in MAP between the 2 groups （P〈0.05）. Conclusion The intubating conditions were similar after anesthetic induction using remifentanil or fentanyl combined with propofol. Furthermore, the inhibition of cardiovascular responses to tracheal intubation with remifentanil is more effective than that with fentanyl.