丙泊酚复合瑞芬太尼用于无肌松药气管插管的临床研究被引量：7

Propofol and Remifentanil for Intubation without Neuromuscular Blockade:A Randomized Clinical Trial

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摘要目的：探讨丙泊酚复合瑞芬太尼用于无肌松药气管插管的最佳剂量,评估诱导期应用此种方法的有效性。方法：择期全麻的患者100例,ASAⅠ~Ⅱ级,随机分为三组。麻醉诱导为丙泊酚2 mg/kg,瑞芬太尼为2μg/kg（Ⅰ组）、3μg/kg（Ⅱ组）和4μg/kg（Ⅲ组）,待两种药物达到药效高峰时行气管插管。观察诱导期和插管后1 min,3 min的血流动力学的变化情况,评估插管满意度。结果：各组的插管满意度如下：Ⅰ组54.2%（19/35）、Ⅱ组83.3%（25/30）、Ⅲ组97.1%（34/35）,随着瑞芬太尼剂量的增加,气管插管满意度增高,气管插管操作时间缩短（P〈0.05）。在诱导过程中,三组患者的MAP和HR下降幅度均较显著（P〈0.05）。结论：丙泊酚复合瑞芬太尼用于无肌松药气管插管是可行的,与复合瑞芬太尼2μg/kg或3μg/kg相比,丙泊酚2 mg/kg复合瑞芬太尼4μg/kg能明显提供更好的气管插管条件,且插管操作时间明显缩短。 Objective： We aimed to evaluate the security and effectiveness of intubation with propofol and remifentanil without neuromuscular blockade, to compare intubation condition followed varying dose of remifentanil and to investigate the optimization dosage. Methods： 100 patients were randomly divided into 3 groups： propofol 2 mg/kg, remifentanil 2 μg/kg（Group Ⅰ）, remifentanil 3μg/kg（Group Ⅱ）, and remifentanil 4 μg/kg（Group Ⅲ） respectively. Ninety seconds after the administration, tracheal intubation were attempted. Intubation condition and hemodynamic changes after hypnotic agent administration, immediately after tracheal intubation, 1and 3 minutes after intubation were observed. Results： Intubation conditions were clinically acceptable in 54.2% in Group Ⅰ compared with 83.3% in Group Ⅱ and 97.1% in Group Ⅲ（P〈0.05）. MAP and HR at post-induction period were significantly decreased in each group（P〈0.05）. Intubation time were decreased as remifentanil dose increased. Conclusions： Propofol and remifentanil for intubation without neuromuscular blockade was safe and effective. The best intubating conditions were produced by the combination of propofol 2mg/kg with remifentanil 4 μg/kg.

作者罗娟于咏婧公维东姜亮岳子勇

机构地区哈尔滨医科大学附属第二医院

出处《现代生物医学进展》 CAS 2016年第15期2889-2891,2927,共4页 Progress in Modern Biomedicine

基金国家自然科学基金项目(30772085)

关键词丙泊酚瑞芬太尼气管插管肌松药 Propofol Remifentanil Intubation Muscle relaxant

分类号 R614 [医药卫生—麻醉学]

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参考文献15

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