不同浓度舒芬太尼复合依托咪酯应用于高龄患者对气管插管时血流动力学的影响  

Influence of different concentration of sufentanil combined with etomidate on hemodynamics of elderly patients with tracheal intubation

作　　者：涂琴琴[1] 

机构地区：[1]湖北省黄石市中心医院麻醉科,湖北黄石435000

出　　处：《实用临床医药杂志》2015年第24期69-71,共3页Journal of Clinical Medicine in Practice

摘　　要：目的观察不同浓度舒芬太尼复合依托咪酯应用于高龄患者对气管插管时血流动力学的影响。方法选择本院收治的需行气管插管的高龄患者60例作为研究对象,按照数字随机法分为3组,每组20例,A组靶控输注舒芬太尼0.30μg/L,B组靶控输注舒芬太尼0.35μg/L,C组靶控输注舒芬太尼0.40μg/L,待达到效应室、血浆质量浓度平衡后靶控输注依托咪酯0.50 mg/L,静脉推注咪达唑仑、维库溴铵,行气管插管。3组患者均于诱导前、舒芬太尼平衡时、依托咪酯平衡时、气管插管即刻等不同时间比较血流动力学相关指标。结果 3组患者诱导前血流动力学指标差异无统计学意义(P>0.05);舒芬太尼、依托咪酯达到平衡时C组心率显著慢于A组、B组(P<0.05);插管即刻B组、C组平均动脉压及心率均低于A组(P<0.05);插管5 min时刻C组平均动脉压及心率均低于A组、B组(P<0.05)。A组于T4时刻出现3例血压超过160 mm Hg,C组于T1、T2时刻出现4例心率低于50次/min,B组未出现血压、心率剧烈波动。结论靶控输注舒芬太尼0.35μg/L负荷依托咪酯应用于高龄患者气管插管,对血流动力学影响较小,可达到满意麻醉效果,效果较佳,安全性较高,具有重要的临床价值。Objective To observe the effect of different concentration of sufentanil combined with etomidate on hemodynamics of elderly patients with tracheal intubation. Methods A total of 60 elderly patients with tracheal intubation were randomly divided into three groups with 20 cases in each group according to random number method. A group adopted target controlled infusion of sufentanil for0. 30μg / L and group B adopted target controlled infusion of sufentanil for 0. 35μg / L while C group applied with target controlled infusion of sufentanil for 0. 40μg / L. Three groups adopted target controlled infusion of etomidate for 0. 50 mg / L after reaching balance of plasma concentration,and were given intravenous injection of midazolam and vecuronium,and implemented tracheal intubation. The hemodynamic indicators were compared before induction at the time of sufentanil balance,etomidate balance and endotracheal intubation. Results There were no significant difference in patients＇ hemodynamics indicators before induction（ P 0. 05）. C group＇ heart rate was significantly slower than A group and B group when sufentanil,etomidate reached balance（ P 0. 05）. B group and C group＇ mean arterial pressure and heart rate were lower than that of group A when intubation（ P 0. 05）. C group＇ mean arterial pressure and heart rate were lower than that of A group and B group at 5 min after intubation（ P 0. 05）. In A group,blood pressure more than 160 mm Hg occurred in 3 cases at T4,heart rate below 50 / min occurred in 4 cases in C group at T1 and T2,group B had no blood pressure and heart rate fluctuations. Conclusion TCI 0. 35 μg / L sufentanil and etomidate for elderly patients with tracheal intubation has less influence on hemodynamics,it can achieve satisfactory anesthesia effect with good effect and high safety,so it is of great value in clinic.

关 键 词：舒芬太尼 依托咪酯 高龄患者 气管插管 血流动力学 

分 类 号：R472.9[医药卫生—护理学]