脑电双频指数监测下不同剂量舒芬太尼麻醉诱导对老年高血压患者气管插管反应的影响  

Influence of different dosages of sulfentanyl anesthesia induction on tracheal intubation response of elderly hypertension patients under bispectral index monitoring

作　　者：黄佳洋[1] 王利祥[1] 严国胜[1] 刘会长[1] 

机构地区：[1]湖北省鄂州市中心医院,湖北鄂州436000

出　　处：《实用临床医药杂志》2014年第1期36-38,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨脑电双频指数（BIS）监测下不同剂量舒芬太尼静脉麻醉诱导对气管插管反应的影响。方法选择择期行全麻手术的老年高血压患者60例,年龄65~85岁,ASAI~Ⅱ级,按不同剂量舒芬太尼随机分为3组,每组20例。Ⅰ组给予舒芬太尼0.2μg/kg,Ⅱ组0.3μg/kg,Ⅲ组0.4μg/kg,在BIS监测下注射丙泊酚2mg/kg和顺式阿曲库铵0.15mg/kg,经口气管插管。记录麻醉诱导前（t0）、诱导给药后（t1）、插管时（t2）、插管后1min（t3）、插管后3min（t4）、插管后5min（t5）的收缩压（SBP）、舒张压（DBP）、心率（HR）及BIS的变化。结果与诱导前相比,给药后3组SBP、DBP、HR及BIS均显著下降（P〈0.05）,以Ⅲ组下降较明显（P〈0.05）;插管时SBP、DBP、HR及BIS均上升,Ⅰ组升高较明显（P〈0.05）,Ⅱ、Ⅲ组升高差异无统计学意义（P〉0.05）;BIS组间比较差异有统计学意义（P〈0.05）,但3组插管后BIS均小于55。结论在老年高血压患者中,0.3μg/kg舒芬太尼麻醉诱导能有效地抑制气管插管应激反应,插管期间血流动力学平稳,是临床使用的最佳剂量。Objective To explore the influence of different dosages of sulfentanyl anesthesia induction on tracheal intubation response of elderly hypertension patients under bispectral index monitoring（BIS）. Methods 60 elderly hypertension patients with general anesthesia were randomly divided into three groups according to the different dosages of sulfentanyl, 20 cases in each group. Quantity of sulfentanyl in groupⅠ, groupⅡ and groupⅢ were 0.2μg/kg, 0.3μg/kg and0.4μg/kg respectively. Under the BIS monitoring,2 mg/kg propofol and 0.15 mg/kg cis-atracurium were injected. Changes of SBP, DBP, HR and BIS at the time points of before induction of anesthesia（t0）, induced after administration（t1）, intubation（t2）, 1 minute after intubation（t3）,3 minutes after intubation（t4）and 5 minutes after intubation（t5）were recorded and compared between all the groups. Results After the treatment, levels of SBP, DBP, HR and BIS decreased significantly in all the groups（P 0.05）, especially in groupⅢ（P 0.05）. During intubation,the levels of SBP,DBP,HR and BIS increased significantly,especially in groupⅠ（P 0.05）, and there were no significant differences between groupⅡ and groupⅢ（P 0.05）. There were significant differences of BIS between all the groups（P 0.05）, and BIS after intubation was less than55 in three groups.Conclusion Application of 0.3μg/kg sulfentanyl anesthesia induction in the treatment of elderly patients with hypertension can effectively inhibit the tracheal intubation response and stabilize hemodynamicsinintubation period,soquantity of 0.3μg/ kg sulfentanylisthe best dosage for clinical application.

关 键 词：舒芬太尼 老年高血压 气管插管反应 

分 类 号：R544.1[医药卫生—心血管疾病]