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題名 | The Optimal Injection Time of Alfentanil for Blunting Circulatory Responses to Tracheal Intubation=使用Alfentanil降低插管時循環反應的最佳時機 |
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作 者 | 鄭淳心; 林珍榮; 黃啟祥; 葉惠敏; 孫維仁; 劉健強; 詹偉弘; | 書刊名 | 麻醉學雜誌 |
卷期 | 43:1 民94.03 |
頁次 | 頁3-9 |
分類號 | 416.52 |
關鍵詞 | 全身麻醉; 氣管內插管; Anesthesia, general; Alfentanil; Intubation, intratracheal; |
語文 | 英文(English) |
中文摘要 | 背景:本研究探討在麻醉誘導期給予alfentanil以減低由喉頭鏡和氣管插管所引起循環反應的最佳時機。方法:75個ASA為一或二的病人隨機分成五組。第一組給予安慰劑,第二、三、四、五組則分別在插管前五、三、一分鐘及三十秒前給予每公斤體重10微克的alfentanil靜脈注射。插管後,用氧氣-笑氣各每分鐘2公升混合並用1.5%的isoflurane來維持麻醉。紀錄全部病人的血液動力學資料,包括心率、血壓以及副作用的出現,並加以比較。結果:各組病人之基本資料及插管時間並無統計差異。第二,三,四組病人在插管後的前三分鐘和第一組比較,均可明顯地降低心跳速率。而在血壓與心率-血壓乘積方面,第二、三、四、五組的病人在插管後的前兩分鐘和第一組比較上則有顯著的差異。93%的第二和第三組病人在給藥後覺得暈眩。在第二組中,有一個病人在給藥後覺得噁心而另一個則是有缺氧的情況發生。結論:此研究顯示,在插管前一分鐘時,使用每公斤10微克的alfentanil會在插管期間有較穩定的血壓、心率和較少的副作用發生。 |
英文摘要 | Background: The aim of this study is to investigate the optimal injection time of alfentanil during induction of anesthesia to blunt the circulatory responses induced by laryngoscopy and tracheal intubation. Methods: Seventy-five patients of ASA class Ⅰ or Ⅱ were randomly assigned to five groups. Group Ⅰ was the placebo group in which the patients received normal saline 2 ml just before induction. Patients in groups Ⅱ, Ⅲ, Ⅳand Ⅴ received alfentanil 10μg/kg at 5, 3, 1 and 0.5 min before intubation respectively. Anesthesia was maintained with 1.5% isoflurane and nitrous oxide in 50% oxygen (2:2 L/min). The patients' heart rate and blood pressure be fore and after intubation were documented and compared. The occurrence of adverse effects was also recorded. Results: Patients' demographic data, baseline hemodynamic profile and the laryngoscopic time did not differ among the five groups. The patients in groups Ⅱ, Ⅲ and Ⅳ showed decreased heart rate compared with group Ⅰ within 3 min after intubation. The patients in group V like those in group I did not show a reduction in heart rate 1 min after intubation. The patients in groups Ⅱ, Ⅲ, Ⅳand Ⅴ all showed reduced systolic blood pressure and rate-pressure product (RPP) 2 min after intubation. The occurrence of hypotension and bradycardia was not different among the five groups; hypertension and high RPP were less in groups Ⅱ, ⅢandⅣas compared with group I. Ninety-three percent patients in group Ⅱ and group Ⅲ suffered from dizziness after alfentanil administration. One patient in group Ⅱ had nausea and an other one patient displayed hypoxemia after alfentanil administration. Conclusions: Considering equal effectiveness and fewer side effects, one minute before intubation is the optimal injection time of alfentanil to blunt the circulator y responses induced by laryngoscopy and tracheal intubation. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。