Nakayama Masayasu, Ichinose Hiromichi, Yamamoto Shuji, Kanaya Noriaki, Namiki Akiyoshi
Department of Anesthesiology, Obihiro Kosei Hospital, Japan.
J Clin Anesth. 2002 Mar;14(2):146-9. doi: 10.1016/s0952-8180(01)00375-0.
To investigate the changes in hemodynamics and hypnotic levels during propofol infusion and tracheal intubation with and without fentanyl.
Randomized, double-blinded study.
Teaching hospital.
40 ASA physical status I adult patients scheduled for elective surgery.
Patients were anesthetized with either propofol (Group P; n = 20) or 2 microg/kg of fentanyl IV followed by propofol (Group PF; n = 20). Propofol was infused at 20 mg/kg/hr throughout the study, and tracheal intubation was performed 10 minutes after the start of propofol infusion.
Bispectral index monitoring (BIS) progressively decreased to about 50 in both groups during infusion of propofol, but no difference was found between the two groups. After tracheal intubation, BIS significantly increased but remained below 60 in both groups. Hypertensive responses to intubation were fewer in Group PF than Group P.
Propofol administration 20 mg/kg/hr for 10 minutes is suitable in suppressing arousal reactions to tracheal intubation, but the addition of fentanyl is required to blunt the hemodynamic responses.
探讨在使用丙泊酚输注以及气管插管过程中，有无芬太尼情况下血流动力学和催眠水平的变化。
随机双盲研究。
教学医院。
40例拟行择期手术的ASA身体状况为I级的成年患者。
患者分别用丙泊酚麻醉（P组；n = 20）或静脉注射2微克/千克芬太尼后再用丙泊酚麻醉（PF组；n = 20）。在整个研究过程中，丙泊酚以20毫克/千克/小时的速度输注，在丙泊酚输注开始10分钟后进行气管插管。
在丙泊酚输注期间，两组的脑电双频指数监测（BIS）均逐渐降至约50，但两组之间未发现差异。气管插管后，两组的BIS均显著升高，但仍低于60。PF组对插管的高血压反应少于P组。
以20毫克/千克/小时的速度输注丙泊酚10分钟适用于抑制气管插管引起的觉醒反应，但需要加用芬太尼来减弱血流动力学反应。
