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不同剂量瑞芬太尼和芬太尼用于全麻诱导的对比观察

Keywords: 瑞芬太尼,芬太尼,异丙酚,全麻,诱导

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Abstract:

目的评价不同剂量瑞芬太尼和芬太尼复合异丙酚全麻诱导对患者血流动力学、麻醉深度的影响,探讨瑞芬太尼复合异丙酚时合适麻醉诱导剂量。方法选择80例ASAI~II级择期手术全麻患者,随机分为四组(每组20例)芬太尼组(F组3~4μg?kg-1)和瑞芬太尼组(R组瑞芬太尼1μg?kg-1后,R1~R3组分别持续泵注瑞芬太尼0.1μg?kg-1?min-1、0.2μg?kg-1?min-1和0.4μg?kg-1?min-1)。全麻诱导咪达唑仑0.05mg?kg-1,芬太尼/瑞芬太尼,顺式苯磺酸阿曲库铵0.15mg?kg-1,丙泊酚1mg?kg-1后持续泵注2mg?kg-1?h-1,5min后行气管插管、机械通气。记录麻醉诱导前的基础状态(T0),气管插管前(T1),插管即刻(T2),插管后3min(T3),插管后5min(T4)及插管后10min(T5)各时间点HR、SBP、DBP、MAP、HRV和BIS的变化。同时记录围插管期心血管不良事件和各组意识消失的时间。结果①与T0相比,T1各组HR、BP均明显下降(P0.05)。③各组病人BIS值与诱导前比较差异有统计学意义(P0.05)。⑤围插管期R1组和F组高血压和心动过速的发生率明显高于R2和R3组(P<0.05),R3组低血压和心动过缓的发生率明显高于R1和R2组(P<0.05)。结论瑞芬太尼缓慢静注负荷剂量1μg?kg-1后持续泵注0.2μg?kg-1?min-1全麻诱导平稳,麻醉深度满意,此剂量的瑞芬太尼复合异丙酚为合适的全麻诱导剂量。

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