CAJ | 학술논문

目的：探讨喷他佐辛对健忘镇痛慢诱导麻醉气管插管应激反应的影响。方法：选择ASAⅠ或Ⅱ级、择期全麻腹部手术患者40例，随机分为对照组芬太尼组（F，n＝20）、喷他佐辛组（P，n＝20）。两组患者均静注咪达唑仑0．03 mg／kg，随后分别静注芬太尼2μg／kg，喷他佐辛0．8 mg／kg。给药5 min后环甲膜穿刺注入1％丁卡因注射液2 mL行喉部表面麻醉，喉麻3 min时在直视下行气管内插管。记录患者T0、T1、T2、T3、T4、T5、T6各时刻的HR（心率）、SBP（收缩压）、DBP（舒张压）、SpO2（血氧饱和度）、BIS（脑电双频指数）；并记录各时刻的镇静程度。结果：两种药物都能有效的抑制穿刺及插管时血压、心率等应激反应，但喷他佐辛组在慢诱导麻醉插管过程中对心血管系统的影响明显优于芬太尼组。结论：0．8 mg／kg喷他佐辛用于健忘镇痛慢诱导麻醉中有效抑制气管插管应激反应且不良反应发生率低。
목적：탐토분타좌신대건망진통만유도마취기관삽관응격반응적영향。방법：선택ASAⅠ혹Ⅱ급、택기전마복부수술환자40례，수궤분위대조조분태니조（F，n＝20）、분타좌신조（P，n＝20）。량조환자균정주미체서륜0．03 mg／kg，수후분별정주분태니2μg／kg，분타좌신0．8 mg／kg。급약5 min후배갑막천자주입1％정잡인주사액2 mL행후부표면마취，후마3 min시재직시하행기관내삽관。기록환자T0、T1、T2、T3、T4、T5、T6각시각적HR（심솔）、SBP（수축압）、DBP（서장압）、SpO2（혈양포화도）、BIS（뇌전쌍빈지수）；병기록각시각적진정정도。결과：량충약물도능유효적억제천자급삽관시혈압、심솔등응격반응，단분타좌신조재만유도마취삽관과정중대심혈관계통적영향명현우우분태니조。결론：0．8 mg／kg분타좌신용우건망진통만유도마취중유효억제기관삽관응격반응차불량반응발생솔저。
Objective To investigate the effect of pentazocine combined with midazolam on intubation stress response in slow induction of anesthesia. Mtheods Forty ASAⅠ~Ⅱpatients were divided into two groups. Anesthesia was induced with midazolam 0.03 mg/kg in both groups,and pentazocine 0.8 mg/kg (i.v.) was given in pentazocine group or fentanyl 2 μg/kg (i.v.) in fentanyl group. Five minutes later, 2 mL of 1% decicaine was administered by cricothyroid membrane puncture to facilitate the intubation.The SpO2, circulatory indexes (HR, SBP, DBP, BIS) and sedation level were measured at T0, T1, T2, T3, T4, T5, T6. Results Both pentazocine and fentanyl can inhibit stress responses to tracheal intubation effectively,but pentazocine group is better than fentanyl group on the cardiovascular stability during slow induction of anesthesia. Conclusion Pentazocine 0.8 mg/kg can inhibit stress responses to tracheal intubation effectively with a low incidence of adverse reactions in the slow induction of anesthesia.