成年女性单次静脉注射芬太尼安全剂量临床研究

Clinical study on safety of single dosage of intravenous fentanyl for adult female

目的 研究成年女性单次静脉注射芬太尼的安全剂量.方法 100例择期全麻手术女性患者,根据单次静脉注射芬太尼剂量不同,随机均分为F0、F1、F2、F3、F4组（n=20）.动、静脉穿刺成功后,F0组静脉输注生理盐水10 ml,F1～ F4组分别静脉输注芬太尼1、2、3、4μg/kg（均用生理盐水稀释至10 ml,注射速度为10μg/s）.记录各组注药前（T0）、注药后5 min（T1）、10 min（T2）时的平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2）、氧分压（PaO2）.同时观察记录各组注药完毕至10 min SpO2下降到90%的患者例数.结果 ①与F0组相比F1、F2组MAP、HR无显著差异（P〉0.05）,F3、F4组MAP、HR有明显差异（P〈0.05）.②与F0组相比F1组SpO2、PaO2无显著差异（P〉0.05）,F2、F3、F4组SpO2、PaO2有明显差异（P〈0.05）.③与F0组相比,F1、F2组SpO2下降到90%的患者例数无显著差异F3、F4组SpO2下降到90%的患者例数有明显筹异（P〈0.05）.结论 成年女性单次静脉注射芬太尼1μg/kg未见MAP、HR、SpO2、PaO2明显改变,计量达到2 μg/kg可以引起MAP、HR、SpO2、PaO2的改变.

Objective To investigate the safe range on singe dosage of intravenous fentanyl in adult female. Methods 100 adult females of elective anesthesia were randomly divided into group F0, group F1, group F2, group F3 and group 174 （ n = 20 each ）. After the procedure of artery and vein puncture, the fentanyl was administered in group F1 （1μg/kg） , F2 （2 μg/kg） , F3 （3 μg/kg） , F4 （4 μg/kg）. As compared group, saline was administed in group F0, and the injection speed was 10μg/s. Mean MAP, HR, SpO2, PaO2 were observed at the time of preinjeetion （T0） , 5 min postinjection（ T1 ） , 10 rain postinjection（T2）. The number of patients whose SpO2 below 90% in 10 rain postinjection were recorded. Results 1. Compared with group F0, MAP of group F1 and F2 had no significant difference, but MAP of group F3 and F4 was significantly decreased （ P 〈 O. 05 ）. 2. Compared with group F0, SpO2, PaO2 of group F1 had no significant difference, but that of F2, I;3 and F4 were significantly decreased（ P 〈 0.05 ）. 3. Compared with group FO, the number of patients whose SpO2 below 90% in F1 and F2 was not significantly increased, while in F3 and F4 the number of patients was significantly increased （ P 〈 0.05 ）. Conclusion The administration of fentanyl 1 p^g/kg does not cause significant decrease of HR, MAP, SpO2 , PaO2, but the administration of fentanyl 2 μg/kg to adult females cause significant decrease of SpO2 , MAP, PaO2.