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[阿托品、芬太尼和阿芬太尼对插管麻醉诱导期心脏循环参数及胸壁僵硬的影响]

[The effect of atropine, fentanyl and alfentanyl on cardiocirculatory parameters and thoracic rigidity in the induction phase of intubation anesthesia].

作者信息

Janik R, Dick W

机构信息

Klinik für Anaesthesiologie der Johannes-Gutenberg-Universität Mainz.

出版信息

Anasth Intensivther Notfallmed. 1988 Oct;23(5):260-4.

PMID:3149155
Abstract

Fentanyl and alfentanil may cause bradycardia if used in combination with succinylcholine during induction of anaesthesia. We therefore studied the influence of atropine, fentanyl and alfentanil on the haemodynamics of 90 urological patients (ASA I, II), who were allocated at random to six groups containing 15 patients each. Induction of anaesthesia was carried out using atropine 0.01 mg/kg-1, fentanyl 0.15 mg or alfentanil 1.5 mg depending on the assigned group: I atropine + fentanyl, II: atropine + alfentanil, III: fentanyl, IV: alfentanil, V: control (no atropine, no analgetic), VI: atropine. Following 2 mg alcuronium and thiopentone 4 mg/kg-1 intubation was performed with 2 mg/kg-1 succinylcholine. Atropine in combination with fentanyl caused a significant increase in heart rate following endotracheal intubation (p less than 0.05). Arrhythmias occurred in the groups with atropine in 4 out of 45 cases, while a chest wall rigidity was not influenced by atropine. Bradycardia occurred after fentanyl or alfentanil with atropine in the same frequency as without atropine. According to our results the routine use of atropine for induction of anaesthesia with thiopentone/fentanyl or alfentanil even in combination with succinylcholine is not required in ASA I or II patients.

摘要

在麻醉诱导期间,如果芬太尼和阿芬太尼与琥珀酰胆碱联合使用,可能会导致心动过缓。因此,我们研究了阿托品、芬太尼和阿芬太尼对90例泌尿外科患者(ASA I、II级)血流动力学的影响,这些患者被随机分为6组,每组15例。根据指定的组别,使用0.01mg/kg-1阿托品、0.15mg芬太尼或1.5mg阿芬太尼进行麻醉诱导:I组:阿托品+芬太尼;II组:阿托品+阿芬太尼;III组:芬太尼;IV组:阿芬太尼;V组:对照组(无阿托品,无镇痛药);VI组:阿托品。静脉注射2mg阿库氯铵和4mg/kg-1硫喷妥钠后,静脉注射2mg/kg-1琥珀酰胆碱进行气管插管。气管插管后,阿托品与芬太尼联合使用可使心率显著增加(p<0.05)。45例使用阿托品的患者中有4例发生心律失常,而胸壁强直不受阿托品影响。使用阿托品时,芬太尼或阿芬太尼后发生心动过缓的频率与未使用阿托品时相同。根据我们的研究结果,对于ASA I或II级患者,即使在与琥珀酰胆碱联合使用时,也无需常规使用阿托品来进行硫喷妥钠/芬太尼或阿芬太尼麻醉诱导。

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