不同剂量艾司洛尔复合舒芬太尼对脊柱侧弯矫形术患者唤醒试验期间应激反应的影响  

Effects of Different Doses of Esmolol-sufentanil on Stress Responses during Wake-up Test in Patients Undergoing Scoliosis Surgery

作　　者：唐玲玲 张承华[2] 董发团[2] 

机构地区：[1]云南省第三人民医院麻醉科,云南昆明650011 [2]成都军区昆明总医院麻醉科,云南昆明650032

出　　处：《昆明医科大学学报》2015年第12期73-76,共4页Journal of Kunming Medical University

基　　金：云南省应用基础研究基金资助项目(2011FZ317)

摘　　要：目的 评价不同剂量艾司洛尔复合舒芬太尼对脊柱侧弯矫形术患者唤醒试验期间应激反应的影响.方法 择期脊柱侧弯矫形术患者60例,年龄18～64岁.采用随机数字表法,将患者随机分为4组（n=15）：生理盐水对照组（C组）;不同剂量艾司洛尔组（E1、E2、E3组）.4组均采用靶控输注舒芬太尼,静脉注射依托咪酯、顺苯磺阿曲库铵麻醉诱导,靶控吸入七氟醚复合靶控输注舒芬太尼、静脉持续输注顺苯磺阿曲库铵维持麻醉.唤醒试验开始,停止输注顺苯磺阿曲库铵、下调舒芬太尼Ce至0.1 ng/m L、下调七氟醚呼气末靶浓度至0,5min后按组别静脉注射生理盐水或0.5、0.75、1.0 mg/kg艾司洛尔.于唤醒试验前30 min、唤醒试验后5 min、唤醒试验后10 min（T0～2）时采集中心静脉血样测定血浆肾上腺素（E）浓度.记录唤醒期间心血管事件的发生情况.结果 唤醒期间高血压、心动过速发生率E1、E2、E3组均低于C组,且E3组低于E1组;T2时血浆E浓度E2、E3组均低于E1,且E3组低于E2组（P〈0.05）.结论 艾司洛尔复合舒芬太尼可降低脊柱侧弯矫形术患者唤醒期间应激反应水平,并呈剂量依赖性.Objective To evaluate the effects of different doses of esmolol-sufentanil on stress responses during wake-up test for seoliosis surgery patients. Methods Sixty patients, aged 18-64 yr, scheduled for scoliosis surgery, were randomly divided into 4 groups （n=15 each） ： saline control group （group C） , and 3 different doses of esmolol groups （groups El, E2 and E3） . Drugs and methods of anesthesia induction and maintenance were the same in four groups. In El-E3 groups, esmolol was injected iv 0.5, 0.75 and 1.0 mg/kg at 5 min after wake-up test, while the same volume of normal saline was given in group C. During intraoperative wake-up test, sufentanil was maintained with target-controlled effect-site concentration at 0.1 ng/mL of four groups. The wake-up test time were recorded： 30 min prior to wake-up test （TO） , 5 rain after wake-up test （T1） and 10 min after wake-up test （T2） . Blood samples were taken for determination of plasma concentrations of epinephrine （E） Cardiovascular events during the wake-up test were recorded. Results Compared with group C, the incidences ofhypertension and tachycardia were significantly lower in El-E3 groups, and the plasma concentrations of E were decreased in E2 and E3 groups. The incidences of hypertension and tachycardia were lower in group E3 than in group El. The plasma concentrations of E were decreased in group E2 than in group E1 and the same in group E3than in group E2 （P 〈 0.05） Conclusion Esmolol-sufentanil can reduce the stress response during wake-up test in patients undergoing scoliosis surgery and in a dose-dependent manner.

关 键 词：药物释放系统 艾司洛尔 舒芬太尼 唤醒试验 脊柱侧凸 

分 类 号：R614[医药卫生—麻醉学]