不同剂量舒芬太尼对脊柱手术患者全麻诱导期血流动力学及血浆皮质醇的影响  

Effects of different dosages of Sufentanil in induced general anesthesia period on blood rheology cortisol in spinal operations

作　　者：张小艳[1,2] 李刚[1] 王令平[2] 

机构地区：[1]山东大学附属省立医院麻醉科,济南250021 [2]临沂市人民医院麻醉科,山东临沂276003

出　　处：《山东大学学报（医学版）》2009年第6期76-79,共4页Journal of Shandong University:Health Sciences

摘　　要：目的观察不同剂量舒芬太尼在脊柱手术患者全麻诱导期对机体血流动力学和Cor的影响。方法将60例择期行脊柱手术患者随机分为S1、S2、S3三组,各组诱导所用舒芬太尼剂量分别为0.2、0.4、0.6μg/kg。各组分别于诱导前(T0,基础值),插管前即刻(T1),插管后1 min(T2)、3 min(T3)、5 min(T4),记录患者SBP、DBP、MAP、HR、SPO2,并在各时点抽取静脉血,用放射免疫法检测血浆Cor浓度。结果同组比较:各组不同时点的SBP、DBP、MAP、HR差异具有统计学意义(P<0.05);各组T1时SBP、DBP、MAP、HR均低于T0时(P<0.05)。组间比较:T1时S1、S2组MAP高于S3组(P<0.05);T2、T3时:S1组SBP、DBP、MAP、HR均高于S2、S3组(P<0.05);T4时:S1、S2组SBP、MAP、HR均高于S3组(P<0.05),S1组DBP高于S2、S3组(P<0.05)。S1组血浆Cor的浓度在T2、T3时高于T0,亦高于相同时点的S2、S3组(P<0.05)。结论和0.2μg/kg舒芬太尼相比,0.4μg/kg和0.6μg/kg均能有效抑制插管时应激反应,0.4μg/kg舒芬太尼更有利于血流动力学稳定。Objective To explore the effects of different dosage of Sufentanil in induced general anesthesia period on blood theology and cortisol in spinal operations. Methods 60 patients who had undergone spinal operations were randomly divided into three groups. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mena arterial pressure （MAP） and heart rate （FIR） were recorded before intubation （T0）, in intubation （T1）, 1 minute later （T2）, 3 minutes later（T3 ）, and 5 minutes later （T4）, at the same time, venous blood was obtained to determine cortisol （Cor） through radio-immunoassay （RIA）. Results SBP, DBP, MAP and HR had significant differences at different times in the same group （ P 〈 0.05） and were lower at T1 than at To in the three groups （ P 〈0.05）. MAP at T1 was higher in groups One and Two than in group Three （ P 〈0.05）. SBP, MAP and HR at T4 were higher in groups One and Two than in group Three （ P 〈 0.05）. DBP was higher in group One than in groups Two and Three （ P 〈 0.05）. Content of cortisol in group One was higher at T2 and T3 than at T4, and also higher than in groups Two and Three at the same time （ P 〈 0.05）. Conclusion Compared with 0.2μg/kg, 0.4μg/kg and 0.6 μg/kg Sufen- tanil can effectively prohibit stress responses in intubation, and 0.4μg/kg of sufentail can produce more rheological stability.

关 键 词：舒芬太尼 脊柱手术 全麻诱导期 血流动力学 血浆皮质醇 

分 类 号：R614[医药卫生—麻醉学] R614.2[医药卫生—外科学]