雷米芬太尼复合异丙酚麻醉诱导的临床应用与观察

Comparison of histamine concentrations and hemodynamic changes after anesthesia induction with remifentanil or fentanyl and propofol

目的对比雷米芬太尼或芬太尼复合异丙酚麻醉诱导及插管后血浆组胺浓度及血流动力学变化。方法将40名病人随机分为两组,诱导后2min行气管插管术。分别记录诱导前、诱导后2min及插管后5min的血浆组胺浓度(HC)、平均动脉压(MAP)、心率(HR)、收缩压与心率乘积(RPP)值。结果两组诱导后及插管后血组胺浓度有明显差异(P<0.05),麻醉诱导后两组间的MAP及HR值比较无显著性差异(P>0.05);但RPP值有差异(P<0.05)。气管插管后两组间的HR值有差异,且组间的MAP及RPP均值有显著性差异(P<0.01)。结论雷米芬太尼组麻醉诱导及插管引起的组胺释放明显低于芬太尼组,并且在抑制插管引起的心血管反应方面优于芬太尼。

Objective Compared assessment between Histamine Concentrations and hemodynamic changes after anesthesia induction with propofol and remifentannil or fentanyl. Methods Forty patients were allocated into two groups.After two minutes, tracheal intubation was performed. Histarine concentrations and MAP and HR and RPP were recorded respectly before anesthesia induction and two minute after induction and five minutes after intubation. Results Histamine Concentrations were different among two groups. MAP and HR and RPP after induction were lower than baseline value in two groups （P〈 0. 05）;MAP and HR were not statistical significance between two groups after anaesthesia induction （P〉0. 05）. Five minutes after tracheal intubation HR was different （P〈 0. 05） and MAP and RPP were dramatically significance between two groups （P〉0. 001）. Conclusions The histamine concentrations are remarkable lower in groupa II than that in groupa I after anesthesia induction with propofol and remifentanil or fentanyl. Furthermore, the control of cardiovascular responses to tracheal intu- bation with remifenanil is more effective than fentanyl.