瑞芬太尼与丙泊酚合剂降低全麻患者气管插管反应的效果观察

Effects of Remifentanil-propofol on Blunting Hemodynamic Response to Tracheal Intubation in Anesthesia Patients

目的观察全麻诱导插管前预先静脉泵入瑞芬太尼与丙泊酚合剂对抑制插管反应的作用和血流动力学稳定方面的效果。方法选取拟全麻患者40例,随机均分为瑞芬太尼与丙泊酚合剂组(R组)和对照组(C组),观察并记录患者各时点的血压、心率、血氧饱和度、脑电双频振数(BIS)值,测量麻醉诱导前和插管后1 min血浆儿茶酚胺浓度。比较气管插管前预先静脉泵入瑞芬太尼与丙泊酚合剂对插管反应的作用。结果与对照组比较,瑞芬太尼与丙泊酚合剂组患者插管即刻,插管后1,3,5min的心率和BIS减低,气管插管后1 min血浆儿茶酚胺浓度降低(P<0.05)。结论在插管前2 min以静脉泵入瑞芬太尼与丙泊酚合剂[5μg(/kg.h)]能较好抑制气管插管时的应激反应。

Objective To observe the effects of remifentanil-propofol on blunting hemodynamic response to tracheal intubation and the stabihzation of cardiovascular system. Methods A Total of 40 anesthesia patients were selected and randomly allocated to remifentanil group （ R group ） and control group （ C group ）. The systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean arterial pressures （MAP）, saturation of blood oxygen （SpO2） as well as BIS index were measured. The concentration of blood serum catecholamine before induction and 1 minute after tracheal intubation was measured to prove the effect on blunting hemodynamic response to tracheal intubation of remifentanilpropofol. Results Compared with group C, the heart rate and BIS value was significantly decreased at the time of endou＇acheal intubation, 1 minute, 3 minute and 5 minute after endotracheal intubation in group R. Retnifenlanil-propofol can suppress the stress-induced catecholamines release at the time of 1 minute after endotracheal intubation as well. Conclusion Two minutes before endotracheal intubation, IV remifentanil-pmpofol at the speed of 5 pμg/kg· h （based on remifentanil ） is effective to attenuate the hemodynamic response to laryngoscopy and tracheal intubation.