CAJ | 학술논문

目的评价氨茶碱预防瑞芬太尼负性变频作用的效果.方法择期全麻患者40例,性别不限,年龄20 ～ 55岁,体重指数18 ～ 25 kg/m2,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为对照组(C组)和氨茶碱预先给药组(AP组),每组20例.C组麻醉诱导前30 min静脉输注生理盐水20 ml,AP组静脉输注氨茶碱3 mg/kg,随后静脉注射咪达唑仑0.1 mg/kg,患者入睡后缓慢静脉注射瑞芬太尼2μg/kg,行人工辅助通气,7 min后静脉注射维库溴铵0.1 mg/kg、芬太尼3μg/kg和依托咪酯0.3 mg/kg,气管插管后行机械通气.于麻醉诱导前(T0)、入睡(T1)、瑞芬太尼注射完后即刻(T2)、1、3、5和7 min(T3-6)时记录HR和MAP;记录T0、T1和T2时低频功率(LF)和高频功率(HF),计算LF/HF比值.结果与T0时比较,两组T2-6时MAP和HR降低,AP组T1时LF和HF降低,LF/HF比值升高(P＜0.05);与C组比较,AP组HR和LF/HF比值升高,T1时LF和HF降低(P＜0.05).结论氨茶碱预防瑞芬太尼对患者心脏的负性变频作用的效果较好.
목적 평개안다감예방서분태니부성변빈작용적효과.방법 택기전마환자40례,성별불한,년령20 ～ 55세,체중지수18 ～ 25 kg/m2,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법분위대조조(C조)화안다감예선급약조(AP조),매조20례.C조마취유도전30 min정맥수주생리염수20 ml,AP조정맥수주안다감3 mg/kg,수후정맥주사미체서륜0.1 mg/kg,환자입수후완만정맥주사서분태니2μg/kg,행인공보조통기,7 min후정맥주사유고추안0.1 mg/kg、분태니3μg/kg화의탁미지0.3 mg/kg,기관삽관후행궤계통기.우마취유도전(T0)、입수(T1)、서분태니주사완후즉각(T2)、1、3、5화7 min(T3-6)시기록HR화MAP;기록T0、T1화T2시저빈공솔(LF)화고빈공솔(HF),계산LF/HF비치.결과 여T0시비교,량조T2-6시MAP화HR강저,AP조T1시LF화HF강저,LF/HF비치승고(P＜0.05);여C조비교,AP조HR화LF/HF비치승고,T1시LF화HF강저(P＜0.05).결론 안다감예방서분태니대환자심장적부성변빈작용적효과교호.
Objective To evaluate the efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil.Methods Forty patients undergoing general anesthesia,aged 20-55 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or 1Ⅱ,were randomly divided into control group (group C) and aminophylline group (group AP),with 20 patients in each group.At 30 min before induction of anesthesia,normal saline 20 ml was infused intravenously in group C,and aminophylline 3 mg/kg was infused intravenously in group AP.Midazolam 0.1 mg/kg was then injected intravenously.Remifentanil 2 μg/kg was injected intravenously after the patients fell asleep and then artificial ventilation was performed.Vecuronium 0.1 mg/kg,fentanyl 3 μg/kg,and etomidate 0.3 mg/kg were injected intravenously 7 min later.The patients were then endotracheally intubated and mechanically ventilated.HR and MAP were recorded before induction of anesthesia (T0),after falling asleep (T1),and at 0,1,3,5 and 7 min (T2-6) after the end of remifentanil injection.Low frequency (LF) and high frequency (HF) were recorded at T0,T1 and T2,and the ratio of LF/HF was calculated.Results Compared with the baseline value at T0,MAP and HR were significantly decreased at T2-6 in the two groups,and LF and HF were decreased at T1,and LF/HF ratio was increased at T1 in group AP.HR and LF/HF ratio were significantly higher,and LF and HF were lower at T1 in group AP than in group C.Conclusion The efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil on the hearts of patients is good.