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中华普通外科学文献(电子版) ›› 2011, Vol. 05 ›› Issue (06) : 520 -523. doi: 10.3877/cma.j.issn.1674-0793.2011.06.014

所属专题: 文献

论著

瑞芬太尼复合艾司洛尔对全麻患者气管插管时心血管指标的影响
陈樱1,(), 陈倩茹1, 沈卫华1   
  1. 1. 510080 广州,中山大学附属眼科医院麻醉科
  • 收稿日期:2011-05-23 出版日期:2011-12-01
  • 通信作者: 陈樱
  • 基金资助:
    广东省医学科学技术研究基金(A2008210)

Effect of remifentanyl combined with esmolol on cardiovascular response during endotracheal intubation under general anesthesia

Ying CHEN1,(), Qian-ru CHEN1, Wei-hua SHEN1   

  1. 1. Zhongshan Ophthalmology Center of Sun Yat-sen University, 510060 Guangzhou, China
  • Received:2011-05-23 Published:2011-12-01
  • Corresponding author: Ying CHEN
  • About author:
    Corresponding author:CHEN Ying, Email:
引用本文:

陈樱, 陈倩茹, 沈卫华. 瑞芬太尼复合艾司洛尔对全麻患者气管插管时心血管指标的影响[J/OL]. 中华普通外科学文献(电子版), 2011, 05(06): 520-523.

Ying CHEN, Qian-ru CHEN, Wei-hua SHEN. Effect of remifentanyl combined with esmolol on cardiovascular response during endotracheal intubation under general anesthesia[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(06): 520-523.

目的

评价瑞芬太尼复合艾司洛尔对全麻患者气管插管时心血管系统的影响。

方法

选择择期上腹部手术患者60例,ASAⅠ~Ⅱ级,随机分为3组(n = 20):瑞芬太尼2 μg/kg组(Ⅰ组),芬太尼4 μg/kg+艾司洛尔1 mg/kg组(Ⅱ组)和瑞芬太尼2 μg/kg+艾司洛尔1 mg/kg组(Ⅲ组)。分别注入上述药物、丙泊酚2 mg/kg和阿曲库铵1.5 mg/kg后行气管插管,机械通气。记录麻醉诱导前(T1)、麻醉诱导后1 min(T2)、气管插管后即刻(T3)、气管插管后1 min(T4)、3 min(T5)及10 min(T6)的HR、收缩压(SP)、舒张压(DP),并于T1、T2、T4时分别采集桡动脉血7 ml,测定血浆肾上腺素(Ad)和去甲肾上腺素(NA)的浓度。

结果

与Ⅰ组比较,Ⅱ组和Ⅲ组HR、SP、DP及血浆Ad和NA的浓度降低(P < 0.05);与Ⅱ组比较,Ⅲ组HR、SP、DP降低(P < 0.05);与T1比较,T2时3组HR、SP、DP及血浆Ad和NA的浓度降低(P < 0.05);Ⅰ组T3时HR、SP、DP升高,Ⅱ组和Ⅲ组差异无统计学意义。

结论

瑞芬太尼复合艾司洛尔可更好地预防全麻患者气管插管时的心血管副作用。

Objective

To evaluate effect of remifentanyl combined with esmolol on cardiovascular response during endotracheal intubation under general anesthesia.

Method

sixty patients (ASA Ⅰ~Ⅱ) who undergoing elective surgery were randomly divided into 3 groups (n = 20): remifentanyl 2 μg/kg (Group Ⅰ), fentanyl 4 μg/kg combined with esmolol 1 mg/kg (Group Ⅱ) and remifentanyl 2 μg/kg combined with esmolol 1 mg/kg (Group Ⅲ). After intravenous admistration of the above drugs and propofol 2 mg/kg and atracurium 1.5 mg/kg, endotracheal tube was intubated and mechanical verntilation was performed. Heart rate (HR), systolic pressure(SP) and diastolic pressure (DP) were recorded before induction (T1), 1 min after induction (T2), at the onset of endotracheal intubation (T3), 1 min after intubation(T4), 3 min after intubation (T5) and 10 min after intubation (T6). And arterial blood sample was taken at T1, T2 and T3 for detecting the levels of serum adrenaline and noradrenaline.

Result

HR, SP, DP and serum levels of adrenaline and noradrenaline were significantly lower than those in Group Ⅰ(P < 0.05). HR, SP and DP in Group Ⅲ were lower than Group Ⅱ. HR, SP and DP at T3 were significantly higher than those at other time points in Group Ⅰ(P < 0.05), but there were no significant difference in those variables between Group Ⅱ and Group Ⅲ.

Conclusion

Remifentanyl combined with esmolol can prevent cardiovascular response during endotracheal intubation of patient under general anesthesia.

表1 3组患者一般临床资料(每组20例)
表2 3组患者各时点SP、DP和HR变化(n = 20, ± s)
表3 3组患者各时点血浆Ad和NA浓度的比较(pg/ml, n = 20, ± s)
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