Kinoshita H, Wakamatsu H, Taira Y, Ishida K, Yonei A
Department of Anesthesia, Kurashiki Central Hospital, Okayama, Japan.
Can J Anaesth. 1995 Mar;42(3):204-8. doi: 10.1007/BF03010677.
High concentrations of inhaled isoflurane can increase heart rate and/or arterial pressure. The purpose of this study was to determine whether fentanyl has a prophylactic effect on the isoflurane-induced circulatory response in adult patients. Thirty patients due to undergo elective surgery were randomly allocated to one of three groups of ten patients. Prior to surgery, one group inhaled 2.5% isoflurane, another inhaled 5.0% isoflurane, and the third group inhaled 5.0% isoflurane and were given fentanyl 2 micrograms.kg-1 i.v. two minutes before induction of anaesthesia. Anaesthesia was induced with thiamylal followed by vecuronium. The lungs were ventilated with 100% oxygen and either 2.5% or 5.0% isoflurane via face mask. Ventilation was continued for five minutes. Heart rate (HR) and mean arterial pressure (MAP) were recorded at two minutes before induction of anaesthesia (baseline), immediately before the induction of anaesthesia, and at three and five minutes after induction, respectively. It was found that 5.0% isoflurane caused an increase in HR compared with baseline (P < 0.01) and with the 2.5% isoflurane (P < 0.05): 2.5% isoflurane did not elicit this response. An increase was also noted in MAP, compared with the 2.5% isoflurane (P < 0.01): 2.5% isoflurane did not elicit this increase. Fentanyl pretreatment attenuated the increases in HR and in MAP that occurred with 5.0% isoflurane (P < 0.01). These results suggest that fentanyl attenuates the enhancement of both HR and MAP from face mask inhalation of a high concentration of isoflurane.
高浓度吸入异氟烷可增加心率和/或动脉压。本研究的目的是确定芬太尼对成年患者异氟烷诱导的循环反应是否具有预防作用。30例择期手术患者被随机分为三组，每组10例。手术前，一组吸入2.5%异氟烷，另一组吸入5.0%异氟烷，第三组吸入5.0%异氟烷，并在麻醉诱导前两分钟静脉注射2微克/千克芬太尼。用硫喷妥钠诱导麻醉，随后给予维库溴铵。通过面罩用100%氧气和2.5%或5.0%异氟烷进行肺通气。通气持续五分钟。分别在麻醉诱导前两分钟（基线）、麻醉诱导前即刻以及诱导后三分钟和五分钟记录心率（HR）和平均动脉压（MAP）。结果发现，与基线相比（P<0.01）以及与2.5%异氟烷组相比（P<0.05），5.0%异氟烷使HR增加：2.5%异氟烷未引起此反应。与2.5%异氟烷组相比，MAP也有升高（P<0.01）：2.5%异氟烷未引起此升高。芬太尼预处理减弱了5.0%异氟烷引起的HR和MAP升高（P<0.01）。这些结果表明，芬太尼可减弱面罩吸入高浓度异氟烷引起的HR和MAP升高。
