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Comparison of Hemodynamic Responses Associated with Tracheal Intubation Under Various Induction Doses of Remifentanil and Propofol

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Open Journal of Anesthesiology 2012年第4期2卷 154-160页

作者： toru goyagi Masashi Yoshimoto Department of Anesthesia and Intensive Care Medicine Akita University Graduate School of Medicine Akita Japan

.Background: The optimal dose of propofol and remifentanil induction to minimize the cardiovascular response associated with tracheal intubation may exist. We investigated the cardiovascular response associated with tracheal intubation when various continuous induction doses of remifentanil in combination with propofol were used. Methods: Seventy- five patients were randomly allocated into 1 of 3 groups: the R-0.4 P-1 group (remifentanil 0.4 μg/kg/min and propofol 1 mg/kg);the R-0.5 P-1 group (remifentanil 0.5 μg/kg/min and propofol 1 mg/kg);and the R-0.4 P-2 group (remifentanil 0.4 μg/kg/min and propofol 2 mg/kg). One minute after remifentanil infusion commenced, a bolus of propofol was injected. Rocuronium 1 mg/kg was administered 1 min after propofol injection following loss of consciousness. Controlled ventilation was then performed for 2 min, and the trachea was intubated 4 min after the start of the remifentanil infusion. The infusion rate of remifentanil was decreased to 0.1 μg/kg/min after intubation. Blood pressure (BP) and heart rate (HR) were measured during this period until 5 min after tracheal intubation. Results: The changes in BP response due to tracheal intubation in the R-0.4 P-1 group were greater than those in the other 2 groups, whereas the HR responses to tracheal intubation were similar among the 3 groups. Conclusion: The combination of remifentanil 0.4 μg/kg/min and propofol 1 mg/kg led to an exaggerated cardiovascular response to tracheal intubation compared with the other combination groups.

关键词： Remifentanil Propofol Tracheal Intubation Presser Response

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The Effect of Nitrous Oxide on the Intraocular Pressure in Patients Undergoing Abdominal Surgery under Sevoflurane and Remifentanil Anesthesia

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Open Journal of Anesthesiology 2016年第6期6卷 85-90页

作者： toru goyagi Takehito Sato Takashi Horiguchi Toshiaki Nishikawa Department of Anesthesia and Intensive Care Medicine Akita University Graduate School of Medicine Akita Japan

Introduction: Although inhalational anesthesia and nitrousoxide (N2O) are known to affect the intraocular pressure (IOP), little is known about the effect of nitrousoxide on the IOP during sevoflurane and remifentanil anesthesia. In the present study, we examined the effect of balanced anesthesia on the IOP. Materials and Methods: After obtaining informed consent, the patients undergoing abdominal surgery under general anesthesia were divided into two groups: N2O group (n = 10) and control group (n = 12). General anesthesia was maintained with remifentanil (0.05 - 0.3 μg/kg/min), 33% O2 and 1.2% sevoflurane to keep ETCO2 of 35 - 40 mmHg following tracheal intubation. After baseline measurement of IOP (T0, 20 minutes after injection of anesthesia), the patients in the N2O group received 67% nitrousoxide, and the patients in the control group received air, with O2 and 1.2% sevoflurane. Then, IOP was measured at 1 hour (T1), 2 hours (T2), and 3 hours (T3) after anesthesia induction in the supineposition. Blood pressure and heart rate were recorded at the same time interval. Results: There was no significant difference in the IOP at any period between the two groups. In both groups, the IOP at the T3 was significantly higher than that at T0. Conclusion: These results suggest that N2O does not affect the IOP in patients undergoing abdominal surgery under sevoflurane and remifentanil anesthesia.

关键词： Intraocular Pressure Nitrous Oxide Balanced Anesthesia

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选择性β1肾上腺素受体阻滞剂艾司洛尔及兰地洛尔对大鼠脊髓缺血和再灌注损伤的神经保护作用

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麻醉与镇痛 2011年第6期7卷 24-28页

作者： Shino Umehara, MD toru goyagi, MD Toshiaki Nishikawa, MD PhD, Yoshitsugu Tobe, BS 韩柳（译）李成辉（校） Department of Anesthesia and Intensive Care Medicine Akita University Graduate School of Medicine Aldta Japan 不详

背景在胸科手术及胸腹部大动脉手术中，截瘫时有发生，它是一种严重的不可预料的并发症。由于超短效选择性β1-肾上腺素受体阻滞剂能在脑缺血后提供神经保护作用，因此我们推断：它们也能减轻大鼠短暂性脑缺血和再灌注所引起的脊髓损伤... 详细信息

背景在胸科手术及胸腹部大动脉手术中，截瘫时有发生，它是一种严重的不可预料的并发症。由于超短效选择性β1-肾上腺素受体阻滞剂能在脑缺血后提供神经保护作用，因此我们推断：它们也能减轻大鼠短暂性脑缺血和再灌注所引起的脊髓损伤。方法将雄性***鼠随机分成四组：生理盐水组（以0．5ml／L速率静脉输注0．9％盐水，n=8）、艾司洛尔组（200μ***^-1·min^-1，n=8）、兰地洛尔组（50μg·kg^-1·min^-1）或假手术组（n=6）。从脊髓缺血前30分钟开始输注生理盐水或药物，并持续到再灌注后24小时。通过主动脉内球囊阻塞联合持续近端动脉低血压10分钟的方法来建立脊髓缺血模型，然后对脊髓进行24小时再灌注。缺血性损伤程度是通过再灌注24小时后的后肢运动损伤指数分数和位于脊髓前角的有活力的运动神经细胞数量来进行评估的。结果艾司洛尔组及兰地洛尔组的运动损伤指数分数较生理盐水组显著性降低（P〈0．05）。组织病理学评估发现艾司洛尔组及兰地洛尔组的脊髓损伤程度较生理盐水组轻（P〈0．05）。结论上述结果显示超短效选择性β1-肾上腺素受体阻滞剂能在大鼠脊髓缺血一再灌注损伤模型中减轻神经损伤。

关键词：肾上腺素受体阻滞剂脊髓缺血模型再灌注损伤神经保护作用兰地洛尔艾司洛尔大鼠脊髓损伤程度

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