不同剂量瑞芬太尼复合异丙酚的气管插管条件及血流动力学的变化

Effects of different doses of remifentanil combined with propofol on tracheal intubating conditions and hemodynamic changes to laryngoscopy and tracheal intubation

Objective To investigate the effect of bolus dose remifentanil and propofol on tracheal intubating conditions and hemodynamic changes to laryngoscopy and tracheal intubation during induction of anesthesia.Methods Sixty ASA physical status I～II patients were administered propofol 2 mg/kg and vecuronium 0.12 mg·kg-1·h-1 and remifentanil 1 μg/kg（groupⅠ）, remifentanil 2 μg/kg（group Ⅱ） or remifentanil 3 μg/kg（group Ⅲ） as a rapid bolus injection.Intubation condition and hemodynamic changes in intra-tracheal intubation were observed. Intubating conditions was assessed using a four-point scoring system.Results Tracheal intubation was successful in all patients.Excellent or good intubation conditions were observed in only 40% in group Ⅰcompared with group Ⅱ and Ⅲ（P < 0.05）.MAP decreased in three groups after induction of anesthesia（P <0.05 or P <0.01）,HR decreased in group Ⅱ and Ⅲ after induction of anaesthesia（P <0.05）.MAP and HR in group Ⅰ and Ⅱ increased significantly after tracheal intubation（P <0.05 or P <0.01）.There were little changes in MAP and HR in group Ⅲ（P >0.05）.The incidence of hypotension in group Ⅲ increased significantly than the group Ⅱ（P <0.05）;but the incidence of bradycardia was no significant difference between the group Ⅱ and Ⅲ（P >0.05）. Conclusion Remifentanil（3 μg/kg） administered with propofol provides acceptable tracheal intubating conditions,and completely inhibites the increase of HR and MAP associated with intubation.

Objective To investigate the effect of bolus dose remifentanil and propofol on tracheal intubating conditions and hemodynamic changes to laryngoscopy and tracheal intubation during induction of anesthesia. Methods Sixty ASA physical status Ⅰ-Ⅱ patients were administered propofol 2 mg/kg and vecuronium 0. 12 mg· kg^-· h^-1 and remifentanil 1μg/kg （ group Ⅰ ）, remifentanil 2 μg/kg （ group Ⅱ ） or remifentanil 3 μg/kg （ group Ⅲ ） as a rapid bolus injection. Intubation condition and hemodynamic changes in intra-tracheal intubation were observed. Intubating conditions was assessed using a four-point scoring system. Results Tracheal intubation was successful in all patients. Excellent or good intubation conditions were observed in only 40% in group Ⅰ compared with group Ⅱand In （P 〈 0.05）. MAP decreased in three groups after induction of anesthesia（P 〈 0.05 or P 〈 0.01 ）, HR decreased in group Ⅱ and Ⅲ after induction of anaesthesia（P 〈 0.05）. MAP and HR in group Ⅰ and Ⅱ increased significantly after tracheal intubatian（ P 〈 0.05 or P 〈 0.01 ）. There were little changes in MAP and HR in group Ⅲ （P 〉 0. 05 ）. The incidence of hypotension in group Ⅲ increased significantly than the group Ⅱ （P 〈0.05） ; but the incidence of bradycardia was no significant difference between the group Ⅱ and Ⅲ （P 〉0. 05）. Conclusion Remifentanil （3 μg/kg） administered with propofol provides acceptable tracheal intubating conditions, and completely inhibites the increase of HR and MAP associated with intubation.