舒芬太尼预防气管插管时眼内压升高的临床研究(1)
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【摘要】 目的 观察单次诱导剂量的利多卡因、芬太尼和舒芬太尼对眼压的影响,并进行对比。方法 60例眼科手术患者,随机分为利多卡因(A)组、芬太尼(B)组和舒芬太尼(C)组,分别于麻醉前、插管瞬间、插管后5 min测量非术眼的眼压(IOP),插管时保持头部不过度后仰,操作在1 min内完成。结果 3组患者插管后,IOP均升高(P<0.05),有显著意义。A组升高的幅度显著高于B、C两组(P<0.05),C组升高的幅度最小。3组患者插管后5 min的IOP与麻醉前相比均有下降,且C组的下降幅度最大,A组的幅度最小。结论 全麻插管时,使用舒芬太尼复合异丙酚行麻醉诱导优于利多卡因、芬太尼。
【关键词】利多卡因;芬太尼;舒芬太尼;气管插管;眼内压
Clinical study of the effect of sulfentanil on preventing high intraocular pressure during induction
CHEN Ying,LING Hong-feng.Department of Anesthesiology,Zhongshan Ophthalmic Center of Sun Yat-sen University,Guangzhou 510060,China
【Abstract】 Objective To observe and compare the effect of a inductive dose of lidocaine,fentanyl and sulfentanil on intraocular pressure(IOP)during anesthesia induction.Methods Sixty patients,scheduled for ophthalmic surgerywere randomly divided into lidocaine,fentanyl and sulfentanil groups.IOP was measured before induction of anesthesia,at intubation and 5-min after intubation.The trachea was intubated with the suitable size of endotracheal tube in one minute.Results IOP increased significantly during induction in all three groups(P<0.05).IOP of group A increased more significantly compared with the other two groups(<0.05),but the degree of increasing is slightest in C group.3 groups of patients 5-min after intubation before anesthesia,compared with the IOP had declined,and the biggest decreasing is C group,A group is the smallest one.Conclusion Administering of sulfentanil with propofol is helpful than lidocaine and fentanyl in preventing high intraocular pressure during induction
【Key words】
Lidocaine; Fentanyl; Sulfentanil; Intubation endotracheal; Intraocular pressure
喉镜窥视下气管插管引起眼内压(intraocular pressure,IOP)升高有一定的危害性,尤其在一些存在有视网膜血液循环障碍、眼底供血不足及高眼压的眼科手术患者,这种危害性更为突出。全身麻醉及用药均可引起眼内压的改变,许多临床工作者也对此进行了深入细致的研究。但舒芬太尼在气管插管反应中对于反应性高眼压具有抑制作用的研究尚无报道。本文通过比较利多卡因、芬太尼和舒芬太尼三种药物对IOP的影响,探求气管插管时预防眼内压升高较好的全麻诱导方法。
1 资料和方法
1.1 病例选择 选择择期眼科手术成年患者60例,ASAⅠ~Ⅱ级,其中男34例,女26例,平均年龄(40.67±10.36)岁,平均体重(57.35±8.25)kg。疾病种类:眼眶手术25例,玻璃体视网膜手术21例,眼整形手术14例,心、肺、肝、肾功能检查未发现异常,无颅内高压、肥胖症和近期手术者。随机分为3组,每组20例,各组患者之间的年龄、性别、体重均无显著差异(P>0 ......
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