芬太尼对地氟醚麻醉诱导和气管插管MAC的影响

Effects of Fentanyl on Induction Characteristics and MAC of Desflurane during Endotracheal Intubation

目的和方法 :观察地氟醚和芬太尼 +地氟醚麻醉诱导的特点及测定两者半数气管插管最低肺泡浓度 (MA CEI50 )。结果 :两组麻醉诱导均很迅速 ,意识消失时间分别为 2 4分钟和 2 5分钟。迅速增加地氟醚浓度 ,地氟醚组引起咳嗽 5 7%、喉痉挛 5 0 %及MAP、HR显著升高。相反 ,芬太尼组很少发生咳嗽和喉痉挛 ,MAP和HR升高不显著。地氟醚组的MACEI50 值为 1 9± 0 3MAC ,静注芬太尼后地氟醚的MACEI50 值降至 1 1± 0 2MAC。结论 :地氟醚麻醉诱导迅速 ,但气道刺激和心血管反应发生率高 ;芬太尼可显著减轻其气道刺激和心血管反应 。

Objective and Methods:The study was done to evaluate the effect of fentanyl on the induction characteristics and MAC of desflurane during endotracheal intubation (MACEI 50 ) in the patients anesthetized with desflurane(group D) or desflurane plus fentanyl(group F).Results:Loss of consciousness was in 2 4 min (group D) and 2 5 min(group F) respectively.The rapid increase of desflurane concentration resulted in coughing(57%),laryngospasm(50%),and significant increments of MAP and HR during gaseous induction.In contrast,coughing and laryngospasm were rare,and MAP and HR remained stable during fentanyl plus desflurane induction.MACEI 50 was significantly reduced from 1 9MAC during gaseous induction to 1 1 MAC during fentanyl plus desflurane induction.Conclusion:Induction of anesthesia with desflurane is rapid,but associated with a high incidence of airway and cardiovascular stimuli during gaseous induction.Fentanly attenuates airway and cardiovascular response to desflurane and produces a decrease in the MACEI 50 of desflurane.