不同剂量的瑞芬太尼诱导对全身麻醉患者的血流动力学影响对比研究

Comparative study of the effect of different doses of remifentanil on hemodynamics in patients with general anesthesia

目的对比全麻过程中应用不同剂量瑞芬太尼进行麻醉诱导对血流动力学的影响。方法将于全麻下接受手术治疗的80例患者随机分为两组,其中瑞芬太尼以1μg/kg静滴进行麻醉诱导者为常规剂量组,以瑞芬太尼以2μg/kg静滴进行麻醉诱导者为高剂量组,每组40例。分析两组手术过程中血流动力学变化情况。结果两组麻醉过程中心率(HR)、收缩压(SBP)、舒张压(DBP)及血清皮质醇(COR)均呈升高趋势(P<0.05),且入手术室及麻醉诱导时HR、SBP、DBP及血清COR比较,差异无统计学意义(P>0.05),而在插管前及插管5min,高剂量组HR、SBP、DBP及血清COR低于常规剂量组,差异有统计学意义(P<0.05)。两组间麻醉诱导过程中均有不同程度的不良反应发生,均于接受对症治疗后好转,两组间比较差异无统计学意义(P>0.05)。结论在全麻的过程中,高剂量瑞芬太尼麻醉诱导可有效的降低麻醉过程对患者血流动力学的影响,其可能与缓解患者应激反应有关。

Objective To compare the effect of anesthesia induction with different doses of remifentanil on hemodynamics during general anesthesia. Methods Eighty patients undergoing surgical treatment under general anesthesia were randomly divided into two groups.Anesthetic inducers who were given Remifentanil with 1 μg/kg intravenous drip were selected as routine dose group,and anesthetic inducers who were given Remifentanil with 2 μg/kg intravenous drip were selected as high dose group, with 40 cases in each group. The hemodynamic changes in the two groups were analyzed. Results The center rate （HR）,systolic pressure （SBP）,diastolic pressure （DBP） and serum cortisol （COR）in the two groups were all increased （P 〈 0.05）.There was no significant difference in the HR,SBP,DBP and serum COR in the two groups （P 〉 0.05） when they were induced in the operation room and induction of anesthesia. Before intubation and intubation 5min,HR,SBP,DBP and serum COR of the high dose group were lower than those of the conventional dose group, the difference was statistically significant （P〈 0.05）.There were different degrees of adverse reactions during the induction of anesthesia in the two groups. They all improved after receiving symptomatic treatment. There was no significant difference between the two groups （P 〉 0.05）. Conclusion In general anesthesia,high dose remifentanil induction can effectively reduce the flow of blood flow to patients.