瑞芬太尼复合丙泊酚全麻诱导对气管插管心血管反应的影响

Effects of remifentanil on the cardiovascular responses to tracheal intubation in combination with propofol during induction of anesthesia

目的观察瑞芬太尼复合丙泊酚全麻诱导对气管插管心血管反应的影响。方法 60例ASAⅠ-Ⅱ择期全麻的患者,随机分为瑞芬太尼组(RF组)和芬太尼组(F组),每组30例。麻醉诱导采用静注咪达唑仑0.1mg/kg,丙泊酚2mg/kg,维库溴胺0.1mg/kg,RF组予瑞芬太尼2μg/kg,F组予芬太尼2μg/kg,3min后气管插管。观察两组患者诱导前、诱导后、气管插管后即刻、1min、3min和5min的血压和心率变化。结果 RF组血压和心率在诱导后和插管后均比诱导前降低(P<0.05),而插管后与诱导后比无变化(P>0.05);F组诱导后与诱导前比血压和心率无明显变化(P>0.05),但插管后即刻、1min和3min比诱导前升高(P<0.05)。RF组诱导后和插管后血压和心率的降低比F组更显著(P<0.05)。结论瑞芬太尼2μg/kg复合丙泊酚能有效地抑制全麻诱导气管插管引起的心血管反应。

Objective To observe the effects of remifentanil on the cardiovascular responses to tracheal intubation on combination with propofol during induction of anesthesia. Methods Sixty voluntary patients, ASA I - II , undergoing general anesthesia for elective surgery, were enrolled and randomly divided into two groups, group RF and group F, with 30 cases in each. The induction of general anesthesia was started with intravenous midazolam 0.1 mg/kg, propofol 2 mg/kg and vecuronium 0. 1mg/kg in all groups. A bolus dose of remifentanil 2 ug/kg and fentanyl 2 ug/kg was given in group RF and F, respectively. The trachea was intubated 3 min after induction. Mean arterial blood pressure （MAP） and heart rate （HR） were measured at the time before induction, after induction, and 0, 1, 3, 5 min after tracheal intubation. Results Comparing with before induction, MAP and HR were significantly decreased after induction and intubation in group RF （ P 〈 0.05 ）, with no significantly differences between after induction and after intubation. MAP and HR were significantly decreased after induction in group F, but increased 0, 1, 3 min after intubation. Both MAP and HR after induction were significantly lower in group RF patients than in those in group F （P 〈 0.05）. Conclusion Remifentanil 2 ug/kg in combination with propofol could effectively inhibit the cardiovascular responses to tracheal intubation after the induction of general anesthesia.