舒芬太尼诱导对气管插管条件和血流动力学的影响  

Effects of Sufentanil on Intubating Conditions and Hemodynamics during General Anaesthesia Induction

作　　者：李民[1] 蔡宏伟[2] 陈雪华[1] 

机构地区：[1]北京潞河医院麻醉科,北京通州110149 [2]湘雅医院麻醉科,湖南长沙410008

出　　处：《贵阳医学院学报》2010年第3期268-271,共4页Journal of Guiyang Medical College

摘　　要：目的:通过对舒芬太尼在全身麻醉诱导中的应用,评价其对插管时应急反应的抑制效果。方法:选择拟行腹腔镜手术的患者60例,随机分为舒芬太尼组(S组)和芬太尼组(F组);两组患者给予咪达唑仑后,S组以舒芬太尼静注,F组以芬太尼静注,然后均给予依托咪酯及罗库溴铵;记录诱导各时点的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR),由同一麻醉医生插管后评价插管条件。结果:(1)在给予芬太尼或舒芬太尼后,SBP、DBP、MAP及HR均较诱导前明显下降(P<0.01),S组SBP、MAP较F组下降明显(P<0.05);在插管后即刻,除HR(P<0.05)外,两组间差异无统计学意义(P>0.05);在插管后2、4min,F组HR高于插管前(P<0.05),S组上述指标与插管前比较P>0.05;(2)S组插管条件评分为优秀者多于F组(P<0.05)。结论:舒芬太尼在全射麻醉诱导中应用,可以使插管前后的血流动力学更加平稳,插管条件更好。Objective：To evaluate inhibitory effects of sufentanil on stress reaction during general anaesthesia induction. Methods：Sixty patients scheduled for laparoscopic operation were randomly divided into sufentainil group（group S,n=30） and fentanyl group （group F,n=30）. After all the patients were given midazolam IV,patients of groups S and F were slowly injected with sufentanil or fentanyl respectively,followed by administering etomidate and rocuronium. At each time point of induction,the haemodynamic variables were recorded; Intubating conditions were graded by the same anaesthetist. Results：（1）Systolic blood pressure （SBP）,diastolic blood pressure （DBP）,mean arterial pressure （MAP）,and hart rate （HR） of patients in group F and group S significantly decreased after injection of fentanyl or sufentanyl （P0.05,P0.01）,and the decreases of SBP,and MAP were more obvious （P0.01） in group S than in group F;There was no difference in observed indexes between the two groups immediately after intubation （P0.05） except HR （P0.05）,which increased in 2 and 4 minuts after intubation than before in group F. All the indexes in group S didn＇t change significantly before and after intubation; （2）There were more cases graded excellent in group S than in group F （P0.05）.Conclusion：Application of sufentanil causes more stable hemodynamics and better intubating conditions.

关 键 词：舒芬太尼 麻醉 静脉 插管法 气管内 血流动力学 

分 类 号：R614.2[医药卫生—麻醉学]