舒芬太尼和芬太尼麻醉对患者气管插管时心血管反应的影响  

Effects of sufentanil and fentanyl on cardiovascular function during intubation in elderly patients

作　　者：陈兴东[1] 史正山[1] 林宁[1] 周志强[1] 段满林[1] 徐建国[1] 

机构地区：[1]南京军区南京总医院麻醉科,210002

出　　处：《临床麻醉学杂志》2006年第8期614-615,共2页Journal of Clinical Anesthesiology

摘　　要：目的比较舒芬太尼和芬太尼对60岁以上患者气管插管时心血管反应的影响。方法60～70岁全麻手术患者60例，随机分为两组，舒芬太尼组（S组，0．3μg／kg）和芬太尼组（F组，3μg／kg），每组30例。分别记录麻醉诱导前（T1）、注药后（T2）、气管插管时（T3）、插管后3、7和10min的以下指标：MAP、HR、每搏输出量（CO）和心脏指数（CI）。结果两组患者T1时MAP、HR、CO和CI组间比较差异均无显著意义；但在同组内T2时的HR、CO和CI较Tt时明显降低（P〈0．05）。T3～T5时与T2时比较，F组CO明显增高（P〈0．05或P〈0．01），S组差异无显著意义。结论舒芬太尼和芬太尼对60岁以上患者全麻诱导下气管插管引起的心血管反应都有抑制作用，但舒芬太尼比芬太尼的效力强，作用持久。Objective To compare the cardiovascular effects of sufentanil with fentanyl used for intubation. Methods Sixty patients （60-70years old） undergoing selective surgery were randomly divided into two groups with 30 cases each. Sufentanil （group S, 0. 3 μg/kg） or fentanyl （group F, 3 μg/kg） was injected intervenously for anesthesia induction. The mean arterial pressure（MAP）, heart rate（HR）, cardiac output（CO）, and cardiac index（CI） were recorded before induction（T1 ）, after drug iniection（T2 ） ,during intubation（T3 ） ,and at 3 min（T4 ）, 7 min（T5 ） and 10 min（T6） after intuhation. Results There was no marked difference in MAP, HR, CO, and CI between the two groups at T1. Compared with throse at T1, HR, CO, and CI were all significandy decreased at T2 to T6 in the two groups. The cardiovascular parameters were all comparable among T2 to T6 in group S,which was not in group F. Conclusion Anesthesia induction with either sufentanil or fentanyl could suppress the cardiovascular responses to intubation in eldrly patients. However, compared with fentanyl, sufentanil could induce a more effective and longer inhibition of stress response.

关 键 词：舒芬太尼 芬太尼 气管插管 心血管反应 

分 类 号：R614[医药卫生—麻醉学]