异丙酚诱导后利多卡因和芬太尼对全身麻醉喉镜和气管插管后血流动力学变化衰减效果的比较研究

F. A. Nasir, J. Salman, S. Asfar
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引用次数: 0

摘要

喉镜检查和气管插管经常与反射性交感反应有关,引起心动过速、高血压和心律失常。这可能对高危患者造成伤害。不同的药理学方法被用来限制或削弱这种反应。本研究旨在评估使用标准麻醉程序异丙酚诱导后喉镜检查和气管插管后的血流动力学变化,并分析利多卡因和芬太尼在减轻全身麻醉下喉镜检查和插管后心血管反应的能力。60名年龄在18岁到50岁之间的患者,不分性别,体重在40到90公斤之间,被随机分为三组,每组20人。所有接受异丙酚2mg/kg静脉滴注,琥珀酰胆碱1mg/kg静脉滴注的患者均采用标准麻醉诱导。第一组接受10cc。生理盐水,第二组芬太尼2µg/kg静脉滴注,第三组利多卡因1.5mg/kg喉镜插管前3分钟滴注。心率和血压在到达手术室时进行无创记录,并在诱导后以及插管后1、3、5、7和10分钟作为基线记录。组间在数量、性别、年龄、体重、ASA分级等方面均无统计学差异。对照组患者的心率、收缩压、舒张压、MAP均在插管后3分钟显著升高(p0.05)。芬太尼和利多卡因在预防收缩压、舒张压和平均动脉血压升高方面同样有效。综上所述,芬太尼2µg/kg和利多卡因1.5mg/kg对减弱喉镜和气管插管压力反应的效果相同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COMPARATIVE STUDY OF THE EFFICACY OF LIGNOCAINE AND FENTANYL AFTER PROPOFOL INDUCTION IN ATTENUATION OF HEMODYNAMIC CHANGES FOLLOWING LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION DURING GENERAL ANESTHESIA
Laryngoscopy and tracheal intubation are constantly connected with a reflex sympathetic reaction bringing about tachycardia, hypertension and dysrrhythmias. This may cause harm in high hazard patients. Different pharmacological methodologies have been utilized to limit or weaken such a reaction. This study aimed to assess the hemodynamic changes following laryngoscopy and endotracheal intubation following propofol induction utilizing a standard anesthesia procedure and to analyze the capability of lignocaine and fentanyl in lessening the cardiovascular reaction to laryngoscopy and intubation amid general anesthesia. Sixty patients aged between eighteen to fifty years, of either gender and ASA class I, weighing between forty to ninety kilograms were planned for elective procedures and were haphazardly allotted into three groups of 20 each. Induction of anesthesia was standard for all patients who received propofol 2mg/kg i.v. and were relaxed with succinylcholine 1mg/kg i.v. The first group received 10cc. normal saline, the second group had fentanyl 2µg/kg i.v. bolus and the third group got lignocaine 1.5mg/kg 3 minutes before laryngoscopy and intubation. Heart rate and blood pressure were recorded noninvasively on arrival to the theatre and considered as a base line record, just after induction and then 1,3,5,7 and 10 minutes following intubation. There were no difference in statistical analysis between the groups regarding number, gender, age, weight and ASA class. There is significant rise in heart rate, systolic BP, diastolic BP and MAP in control group particularly in the first 3 minutes following intubation (p<0.05). Both fentanyl and lignocaine gave minimal protection against rise in heart rate after laryngoscopy and intubation and there is no significant difference between the two drugs (p>0.05). Both fentanyl and lignocaine were equally effective in prevention of major rise in systolic blood pressure, diastolic blood pressure and mean arterial blood pressure. In conclusion, Fentanyl 2µg/kg and lignocaine 1.5mg/kg are both equally effective for attenuation of laryngoscopy and endotracheal intubation pressor response.
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