不同剂量舒芬太尼对直肠癌患者全麻气管插管应激反应和血流动力学的影响  

Effects of Different Doses of Sufentanil on the Stress Response and Hemodynamics of Tracheal Intubation under General Anesthesia in the Patients with Rectal Cancer

作　　者：梁东锋 邓海波 王秋锋 姚远 梁启胜[3] LIANG Dong-feng;DENG Hai-bo;WANG Qiu-feng;YAO Yuan;LIANG Qi-sheng(Department of Anesthesiology,Fuyang people's Hospital,Anhui Province,Fuyang,Anhui,236000,China;General surgery department of Fuyang people's Hospital of Anhui Province,Fuyang,Anhui,236000,China;Department of Anesthesiology,the First Affiliated Hospital of Bengbu Medical College,Anhui Province,Bengbu,Anhui,233004,China)

机构地区：[1]安徽省阜阳市人民医院麻醉科,安徽阜阳236000 [2]安徽省阜阳市人民医院普外科,安徽阜阳236000 [3]安徽省蚌埠医学院第一附属医院麻醉科,安徽蚌埠233004

出　　处：《现代生物医学进展》2020年第14期2766-2770,共5页Progress in Modern Biomedicine

基　　金：安徽省自然科学基金项目(1608085MH198)。

摘　　要：目的:研究不同剂量舒芬太尼对直肠癌患者全麻气管插管应激反应和血流动力学的影响。方法:选择2017年1月~2019年12月在我院择期进行腹腔镜直肠癌切除术患者90例作为研究对象,依据随机数字表法分为A组、B组、C组,每组各30例。A组:0.4μg/kg舒芬太尼、B组:0.5μg/kg舒芬太尼,C组:0.6μg/kg舒芬太尼,观察并比较各组气管插管应激反应,插管前后血流动力学指标,麻醉恢复指标以及不良反应的发生情况。结果:插管后1 min及3 min,各组去甲肾上腺素(NA)、肾上腺素(AD)水平均较基础值显著上升,A组以上指标依次高于B组、C组(P<0.05);A组、B组心率、平均动脉压水平均较基础值上升,A组以上指标高于B组,C组以上指标低于基础值(P<0.05);A组、B组BIS值均较基础值下降,A组以上指标高于B组、C组(P<0.05)。A组、B组自主呼吸恢复时间、呼吸睁眼时间和拔管时间比较无统计学差异(P>0.05),但均短于C组(P<0.05)。A组呛咳率显著高于B组、C组,C组恶心呕吐率高于A组、B组(P<0.05)。结论:0.5μg/kg舒芬太尼能够减轻直肠癌全麻气管插管应激反应,减少血流动力学波动,且无苏醒延长,不增加药物不良反应。Objective:To study the effects of different doses of sufentanil on the stress response and hemodynamics of in rectal cancer patients undergoing tracheal intubation under general anesthesia.Methods:Ninety patients undergoing elective laparoscopic rectal cancer resection in our hospital from January 2017 to December 2019 were selected as research objects and divided into group A,group B and group C according to random number table method,with 30 cases in each group.Group A:0.4μg/kg sufentanil;Group B:0.5μg/kg sufentanil;Group C:0.6μg/kg sufentanil.The stress response,hemodynamic index before and after intubation,anaesthesia recovery index and incidence of adverse reactions were observed and compared between different groups.Results:At 1 min and 3 min after intubation,the levels of norepinephrine(NA)and epinephrine(AD)in each group were significantly increased compared with the basal values,the above indexes in group A were successively higher than those in group B and group C(P<0.05).The heart rate and average arterial pressure of group A and group B were all higher than the baseline values,which were higher in group A than those of group B,while those of group C were lower than the baseline values(P<0.05).The BIS values of group A and group B decreased from the base values,and the above indexes of group A were higher than those of group B and group C(P<0.05).There was no statistically significant difference between group A and group B in the recovery time of spontaneous breathing,time of respiratory opening and time of extubation(P>0.05),but all of them were shorter than group C(P<0.05).The rate of choking in group A was significantly higher than that in group B and group C,and the rate of nausea and vomiting in group C was significantly higher than that in group A and group B(P<0.05).Conclusion:0.5μg/kg sufentanil can reduce the stress response of tracheal intubation under general anesthesia in rectal cancer,reduce the fluctuation of hemodynamics,and do not prolong resuscitation and increase the adverse drug

关 键 词：直肠癌 不同剂量舒芬太尼 气管插管应激反应 血流动力学 

分 类 号：R735.37[医药卫生—肿瘤] R614[医药卫生—临床医学]