Background The authors found no study to compare the efficacy of bolus dose fentanyl and remifentanil blunting the cardiovascular intubation response in children, so they designed this randomized, double-blind clinica...Background The authors found no study to compare the efficacy of bolus dose fentanyl and remifentanil blunting the cardiovascular intubation response in children, so they designed this randomized, double-blind clinical study to assess the effects of remifentanil 2 μg/kg and fentanyl 2 μg/kg by bolus injection on the cardiovascular intubation response in healthy children.Methods One hundred and two children, the American Society of Anesthesiologists （ASA） physical status 1-2 and scheduled for elective plastic surgery under general anesthesia, were randomly divided into one of two groups to receive the following treatments in a double blind manner： remifentanil 2μg/kg （Group R） and fentanyl 2 μg/kg （Group F） when anesthesia was induced with propofol and vecuronium. The orotracheal intubation was performed using a direct laryngoscope. Blood pressure （BP） and heart rate （HR） were recorded before anesthesia induction （baseline values）, immediately before intubation, at intubation and every minute for 5 minutes after intubation. The percent changes of systolic blood pressure （SBP） and HR relative to baseline values and the rate pressure product （RPP） at every observing point were calculated. The incidences of SBP and HR percent changes 〉30% of baseline values and RPP 〉22 000 during the observation were recorded.Results There were no significant differences between groups in the demographic data, baseline values of BP and HR and the intubation time. As compared to baseline values, BP, HR and RPP at intubation and their maximum values during observation increased significantly in Group F, but they all decreased significantly in Group R. BP, HR and RPP at all observed points, and their maximum values during the observation, were significantly different between groups. There were also significant differences between groups in the percent change of SBP and HR relative to baseline values at all observed points and their maximum percent changes during the observation. The incidences of SBP and HR percent increased 〉30% of the baseline values and RPP 〉22 000 during the observation, were significantly higher in Group F than in Group R, but the incidences of SBP and HR percent decreased 〉30% of baseline values were significantly lower in Group F compared with Group R.Conclusions When used as part of routine anesthesia induction with propofol and vecuronium in children, fentanyl 2 μg/kg by bolus injection fails to effectively depress the cardiovascular intubation response. Remifentanil 2 μg/kg by bolus injection can completely abolish the cardiovascular intubation response, but also cause more adverse complications of temporary siclnificant cardiovascular depression.展开更多
目的观察全麻诱导气管插管时瑞芬太尼联合芬太尼对患者心血管反应的影响。方法 45例老年手术患者随机分为芬太尼组(F)、瑞芬太尼复合芬太尼组(RF)、瑞芬太尼(R) 3组,每组15例。分别记录诱导前5 min (T0)、插管即刻(T1)、插管后1 min (T2...目的观察全麻诱导气管插管时瑞芬太尼联合芬太尼对患者心血管反应的影响。方法 45例老年手术患者随机分为芬太尼组(F)、瑞芬太尼复合芬太尼组(RF)、瑞芬太尼(R) 3组,每组15例。分别记录诱导前5 min (T0)、插管即刻(T1)、插管后1 min (T2)、插管后3 min (T3)、插管后5 min (T4)患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR),并观察有无低血压、心动过缓、呛咳、肌强直等并发症。结果 F组在T2、T3和T4时间点,HR数值较RF组和R组明显增高,差异有统计学意义(P<0. 05); R组在T1和T2时间点,HR数值明显较F组和RF组慢,差异有统计学意义(P<0. 05)。比较SBP、DBP、MAP指标,RF组在T2、T3和T4时间点明显低于F组和R组,差异有统计学意义(P<0. 05)。结论全麻诱导时复合小剂量的瑞芬太尼和芬太尼,老年患者气管插管应激反应更小,血流动力学更平稳。展开更多
文摘Background The authors found no study to compare the efficacy of bolus dose fentanyl and remifentanil blunting the cardiovascular intubation response in children, so they designed this randomized, double-blind clinical study to assess the effects of remifentanil 2 μg/kg and fentanyl 2 μg/kg by bolus injection on the cardiovascular intubation response in healthy children.Methods One hundred and two children, the American Society of Anesthesiologists （ASA） physical status 1-2 and scheduled for elective plastic surgery under general anesthesia, were randomly divided into one of two groups to receive the following treatments in a double blind manner： remifentanil 2μg/kg （Group R） and fentanyl 2 μg/kg （Group F） when anesthesia was induced with propofol and vecuronium. The orotracheal intubation was performed using a direct laryngoscope. Blood pressure （BP） and heart rate （HR） were recorded before anesthesia induction （baseline values）, immediately before intubation, at intubation and every minute for 5 minutes after intubation. The percent changes of systolic blood pressure （SBP） and HR relative to baseline values and the rate pressure product （RPP） at every observing point were calculated. The incidences of SBP and HR percent changes 〉30% of baseline values and RPP 〉22 000 during the observation were recorded.Results There were no significant differences between groups in the demographic data, baseline values of BP and HR and the intubation time. As compared to baseline values, BP, HR and RPP at intubation and their maximum values during observation increased significantly in Group F, but they all decreased significantly in Group R. BP, HR and RPP at all observed points, and their maximum values during the observation, were significantly different between groups. There were also significant differences between groups in the percent change of SBP and HR relative to baseline values at all observed points and their maximum percent changes during the observation. The incidences of SBP and HR percent increased 〉30% of the baseline values and RPP 〉22 000 during the observation, were significantly higher in Group F than in Group R, but the incidences of SBP and HR percent decreased 〉30% of baseline values were significantly lower in Group F compared with Group R.Conclusions When used as part of routine anesthesia induction with propofol and vecuronium in children, fentanyl 2 μg/kg by bolus injection fails to effectively depress the cardiovascular intubation response. Remifentanil 2 μg/kg by bolus injection can completely abolish the cardiovascular intubation response, but also cause more adverse complications of temporary siclnificant cardiovascular depression.
文摘目的观察全麻诱导气管插管时瑞芬太尼联合芬太尼对患者心血管反应的影响。方法 45例老年手术患者随机分为芬太尼组(F)、瑞芬太尼复合芬太尼组(RF)、瑞芬太尼(R) 3组,每组15例。分别记录诱导前5 min (T0)、插管即刻(T1)、插管后1 min (T2)、插管后3 min (T3)、插管后5 min (T4)患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR),并观察有无低血压、心动过缓、呛咳、肌强直等并发症。结果 F组在T2、T3和T4时间点,HR数值较RF组和R组明显增高,差异有统计学意义(P<0. 05); R组在T1和T2时间点,HR数值明显较F组和RF组慢,差异有统计学意义(P<0. 05)。比较SBP、DBP、MAP指标,RF组在T2、T3和T4时间点明显低于F组和R组,差异有统计学意义(P<0. 05)。结论全麻诱导时复合小剂量的瑞芬太尼和芬太尼,老年患者气管插管应激反应更小,血流动力学更平稳。
