Hemodynamic stability during induction of anesthesia and tracheal intubation with propofol plus fentanyl, ketamine, and fentanyl-ketamine.
Hemodynamic stability during induction of anesthesia and tracheal intubation with propofol plus fentanyl, ketamine, and fentanyl-ketamine.
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DOI：
10.1007/s005400170001
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发表时间：
2001-01-01
影响因子：
2.8
通讯作者：
Dohi, S
中科院分区：
文献类型：
--
作者：
Hayakawa-Fujii, Y;Takada, M;Dohi, S
目的：观察异丙酚+芬太尼、异丙酚+氯胺酮、异丙酚+芬太尼+氯胺酮麻醉诱导插管期间的血流动力学和心脏稳定性。方法：45例成年患者随机分为3组：异丙酚(2 mg/kg)+芬太尼(3 mg/kg)(PF)、异丙酚(2 mg/kg)+氯胺酮(0.1 mg/kg)(PK)、异丙酚(2 mg/kg)+芬太尼(3 mg/kg)+氯胺酮(PFK)。通过测量血压(BP)、心率(HR)和心输出量(CO)的变化来评估血流动力学反应。结果：麻醉诱导期间PK组的BP和HR变化明显大于PF和PFK组。注射异丙酚后，PF组和PFK组的心脏指数(CI)显著低于基础值，而PK组的CI无明显变化。气管插管后，仅PF组和PK组的BP和HR显著升高，且仅PK组达到显著高于基线水平。气管插管时的CO反应为：PK组+GT；PF组+GT；PFK组。结论：异丙酚+芬太尼+氯胺酮比异丙酚+芬太尼或异丙酚+氯胺酮能更好地减少麻醉诱导和气管插管相关血流动力学指标的波动。
PURPOSE: This study was conducted to investigate hemodynamic and cardiac stability during anesthesia induction and intubation, using propofol plus fentanyl, propofol plus ketamine, and propofol plus fentanyl and ketamine.METHODS: Forty-five adult patients were randomly allocated to one of three groups according to the agents used for induction: propofol (2 mg/kg) plus fentanyl (3 microg/kg) (PF), propofol (2 mg/kg) plus ketamine (0.1 mg/kg) (PK), and propofol (2 mg/kg) plus fentanyl (3 microg/kg) plus ketamine (0.1 mg/kg) (PFK). Hemodynamic responses were assessed by measuring changes in blood pressure (BP), heart rate (HR), and cardiac output (CO; using dye dilution combined with pulse dye densitometry [PDD]).RESULTS: BP and HR changes during the induction of anesthesia tended to be greater in the PK group than in the PF and PFK groups. After the injection of propofol, the cardiac index (CI) fell significantly below baseline values in the PF and PFK groups, but remained unchanged in the PK group. After tracheal intubation, BP and HR increased significantly only in the PF and PK groups, and reached a level significantly above baseline values only in the PK group. The CO responses to tracheal intubation were: PK group > PF group > PFK group.CONCLUSION: A combination of propofol plus fentanyl plus ketamine would provide greater reduction of fluctuations in hemodynamic variables associated with induction of anesthesia and tracheal intubation than combinations of propofol plus fentanyl or propofol plus ketamine.