Ferreira D A, Santos I A, Nunes C S, Amorim P, Antunes L M
Universidade de Trás-os-Montes e Alto Douro, Departamento de Zootecnia, Quinta dos Prados, Apartado 1013, 5000-911 Vila Real, Portugal.
Rev Esp Anestesiol Reanim. 2005 Nov;52(9):550-3.
Intravenous propofol and remifentanil are often used in anesthesia. The combined use of these drugs tends to cause hemodynamic depression. We describe the absence of hemodynamic effects in response to infusion of propofol and remifentanil when hydroxyethyl starch (HES) 130/0.4 was also administered. During induction, because blood volume needed to be replaced, two patients aged 62 and 65 years received intravenous HES 130/0.4. They then received a single dose of 2 microg x kg(-1) of remifentanil during total intravenous anesthesia (TIVA) with propofol and remifentanil before placement of a Mayfield head holder. No changes in mean blood pressure or heart rate were observed in either patient after the remifentanil bolus when they have received HES 130/0.4 during TIVA with propofol and remifentanil HES 130/0.4 may play an active role in preventing a hemodynamic response to remifentanil bolus. This hypothesis should be tested in a randomized controlled trial.
静脉注射丙泊酚和瑞芬太尼常用于麻醉。这些药物联合使用往往会导致血流动力学抑制。我们描述了在同时给予羟乙基淀粉（HES）130/0.4时，输注丙泊酚和瑞芬太尼不会产生血流动力学效应。在诱导期间，由于需要补充血容量，两名年龄分别为62岁和65岁的患者接受了静脉注射HES 130/0.4。然后，他们在使用丙泊酚和瑞芬太尼进行全凭静脉麻醉（TIVA）期间，在放置梅菲尔德头架之前接受了单剂量2微克/千克的瑞芬太尼。当在丙泊酚和瑞芬太尼TIVA期间接受HES 130/0.4后，两名患者在推注瑞芬太尼后平均血压和心率均未观察到变化。HES 130/0.4可能在预防瑞芬太尼推注引起的血流动力学反应中发挥积极作用。这一假设应在随机对照试验中进行检验。
