氢吗啡酮和芬太尼对全麻诱导气管插管应激反应的影响

目的：：比较盐酸氢吗啡酮和芬太尼对全麻诱导气管插管应激反应的影响。方法：择期全麻行口腔颌面部良性肿物切除术的患者60例，随机分为三组。建立静脉通路后，H1组、H2组、F组患者分别静脉注射氢吗啡酮0.2mg、0.4mg和芬太尼0.2mg，5min之后常规诱导气管插管。记录患者入室后5min(T0)，插管前即刻(T1)，插管即刻(T2)，插管后1min(T3)、3min(T4)、5min(T5)、10min(T6)的平均动脉压(MAP)和心率(HR)。结果：三组药物对MAP、HR的影响存在组间差异，其中H2组不同时相MAP、HR较平稳。结论：0.4mg盐酸氢吗啡酮和0.2mg芬太尼均能有效减弱全麻气管插管引起的应激反应，且0.4mg盐酸氢吗啡酮在不同时相对患者MAP、HR的影响更小，全麻诱导插管更为平稳。

EFFECTS OF HYDROMORPHONE AND FENTANYL ON STRESS REACTION DURING TRACHEAL INTUBATION OF GENERAL ANESTHESIA

ABSTRACT]Objective: To compare the effects of hydromorphone hydrochloride and fentanyl on stress reaction in patients during tracheal intubation of general anesthesia.Methods: 60 patients with oral and maxillofacial region benign tumor who were undergoing selective general anesthesia surgery were randomly divided into H1 group, H2 group and F group (n=20). The patients in H1 group, H2 group and F group were respectively injected 0.2mg hydromorphone hydrochloride, 0.4mg hydromorphone hydrochloride and 0.2mg fentanyl; 5 minutes later, the patients accepted anesthesia induction and intubation. The mean arterial pressure (MAP) and heart rate (HR) of patients were recorded at 5 minutes after entering operation room (T0), immediately before intubation (T1), intubation (T2), 1 minute after intubation (T3), 3 minutes after intubation (T4), 5 minutes after intubation (T5) and 10 minutes after intubation (T6).Results:The effects of 3 drugs on MAP and HR were different. The MAP and HR of patients in H2 group were relatively stable at different time point. Conclusions: 0.4mg hydromorphone hydrochloride and 0.2mg fentanyl all can weaken the stress reaction during tracheal intubation of general anesthesia. Moreover, 0.4mg hydromorphone hydrochloride has less effects on MAP and HR at different time point, and induction intubation of general anesthesia is more smoothly.