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[1]郭晓春,胡宁利.全麻诱导期芬太尼复合不同静脉麻醉药时适宜用量的探讨[J].医学研究与战创伤救治(原医学研究生学报),2008,10(03):195.
　GUO Xiao-chun,HU Ning-li.Optimal dosage of fentanyl combined with intravenous anesthetics during anesthesia induction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2008,10(03):195.
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全麻诱导期芬太尼复合不同静脉麻醉药时适宜用量的探讨()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第10卷
期数:
2008年03期
页码:
195
栏目:
出版日期:
2008-05-20

文章信息/Info

Title:
Optimal dosage of fentanyl combined with intravenous anesthetics during anesthesia induction
文章编号:
1672-271X(2008)03-0195-04
作者:
郭晓春1 ; 胡宁利2
1.解放军第117医院麻醉科，浙江杭州 310013；2.解放军第97医院麻醉科，江苏徐州 221004
Author(s):
GUO Xiao-chun1; HU Ning-li2
1.Anesthesia Department, the 117th Hospital of PLA, Hangzhou 310013,Zhejiang,China;2.Anesthesia Department, the 97th Hospital of PLA,Xuzhou 221004,Jiangsu,China
关键词:
芬太尼; 气管插管; 心血管应激反应
Keywords:
Fentanyl;  Endotracheal intubation; Hernodynamic change
分类号:
R614.2
DOI:
-
文献标志码:
A
摘要:
目的 探讨全麻诱导期芬太尼复合静脉麻醉药时，既能预防气管插管心血管应激反应，又无过度降压效应的适宜剂量。方法 全麻气管插管下择期手术患者162例，按麻醉配方分7组:组1硫喷妥钠5 mg/kg，芬太尼7 μg/kg(n=25)；组2依托咪酯0.3 mg/kg，芬太尼7 μg/kg(n=28)；组3依托咪酯0.3 mg/kg，芬太尼5 μg/kg(n=27)；组4咪唑安定(力月西)0.05 mg/kg，依托咪酯0.3 mg/kg，芬太尼6 μg/kg(n=22)；组5异丙酚2 mg/kg，芬太尼7 μg/kg(n=15)；组6异丙酚2 mg/kg，芬太尼5 μg/kg(n=15)；组7异丙酚2 mg/kg，芬太尼3 μg/kg(n=30)。记录麻醉诱导前、诱导后、插管即刻、插管后1、3、5、7、10 min收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)。结果 各组进行自身对照，与基础值比较: 组1，SBP、DBP和MAP在诱导后、插管后5、7、10 min明显降低(P<0.05),HR在诱导后和插管1 min明显增快(P<0.05)。组2，各项指标在各时点之间无显著差异(P>0.05)。组3，SBP在插管1 min时显著增高(P<0.01)。组4，仅SBP在诱导后明显降低(P<0.05)。组5，SBP、DBP、MAP在诱导后和插管后各时点显著降低(P<0.01)。组6，SBP、DBP、MAP在诱导后和插管后7、10 min显著降低(P<0.01)。组7，SBP、DBP、MAP仅在诱导后显著降低(P<0.01)。结论 静脉麻醉药在推荐的诱导剂量基础上，硫喷妥钠或依托咪酯伍用芬太尼7 μg/kg,依托咪酯加咪唑安定伍用芬太尼6 μg/kg,异丙酚伍用芬太尼3 μg/kg较为适宜。
Abstract:
Objective To investigate optimal dosage of fentanyl combined with intravenous anesthetics for the prevention of hemodynamic changes to endotracheal intubation during anesthesia induction. Methods 162 patients were randomly divided into seven groups: group Ⅰ thiopental 5 mg/kg and fentanyl 7 μg/kg (n=25); group Ⅱ etomidate 0.3 mg/kg and fentanyl 7 μg/kg (n=28); group Ⅲ etomidate 0.3 mg/kg and fentanyl 5 μg/kg (n=27); groupⅣ midazolam 0.05 mg/kg, etomidate 0.3 mg/kg and fentanyl 6 μg/kg (n=22); groupⅤ propofol 2 mg/kg and fentayl 7 μg/kg (n=15); groupⅥ propofol 2 mg/kg and fentanyl 5 μg/kg (n=15); groupⅦ propofol 2 mg/kg and fentanyl 3 μg/kg (n=30). SBP,DBP ,MAP,HR,RPP were monitored before and after induction, 0,1,3,5,7,10 min after intubations. Results SBP,DBP,MAP decreased after induction, and 5,7,10 min after intubations. HR increased 1 min after intubation in group Ⅰ (P<0.05). Hemodynamics was stable during anesthesia induction in group Ⅱ. SBP increased 1 min after intubation in group Ⅲ(P<0.01). SBP decreased after induction in group Ⅳ(P<0.05). SBP,DBP,MAP decreased significantly during induction and intubations in group Ⅴ(P<0.01). SBP,DBP,MAP decreased after intubations and 7,10 min after intubations in group Ⅵ(P<0.01). SBP,DBP,MAP decreased only after inductions in group Ⅶ(P<0.01).Conclusion Fentanyl 7 μg/kg combined with thiopental or etomidate, fentanyl 6 μg/kg combined with midazolam and etomidate, fentanyl 3 μg/kg combined with propofol are optimum dose of the prevention of homonymic response to end-intubations during anesthesia induction.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2013-11-22