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기관내 삽관시 Slow induction과 Fentanyl 정주가 심혈역학적 변화에 미치는 영향
윤재천,채종한,조남수,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.2
Tracheal intubation is accompanied by varying degrees of sympathetic stimulation as reflected by increases in blood pressure and heart rate. Several clinical trials to reduce these effects by deepening anesthesia, using pharmacologic agents such as alpha and beta blockers,calcium channel blockers, fentanyl and lidocaine have been reported. To evaluate the effects of slow induction and fentanyl on responses of cardiovascular system induced by endotracheal intubation, we administered thiopental sodium 5㎎/㎏ (group Ⅰ), slow induction with O_(2)-N_(2)O-halothane( group Ⅱ), fentanyl 3uμ/㎏ with thiopental sodium 4㎎/㎏(group Ⅲ) for induction of anesthesia, and measured systolic and diastolic pressures, and heart rates before induction, and at 1,2,3,4, and 5 minutes after intubation. 1) In group Ⅰ, intubation caused a significant increase in systolic pressure (10%) diastolic pressure (15%) and heart rate (28%) at 1 min. after intubation but each parameter returned to the normal level within 5 min. 2) In group Ⅱ, increases in systolic pressure (12%), diastolic pressure (22%) and heart rate (23%) at 1 min. after intubation but there were no significant differences compared to group Ⅰ. 3) In group Ⅲ, the increase in systolic and diastolic pressure induced by intubation was abolished by fentanyl and showed significant decrease compared to group Ⅱ, increase in heart rate (4%) at 1 min. after intubation but were of no significance, and showed significant decrease compared to group Ⅱ but not at 3 min., 4 min. after intubation. These results suggested that a low dose of fentanyl significantly blunts postintubation hypertenion and tachycardia when used as an adjunct to thiopental sodium.