艾司氯胺酮与舒芬太尼对气管插管血流动力学的影响比较  

Comparison of the effects of esketamine and sufentanil on hemodynamics of tracheal intubation

作　　者：岳芳 陈方[1] 赵紫玉 姚溪[1] 白宁[1] YUE Fang;CHEN Fang;ZHAO Ziyu;YAO Xi;BAI Ning(Anesthesiology Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院麻醉科,陕西西安710068

出　　处：《临床医学研究与实践》2023年第32期37-40,共4页Clinical Research and Practice

基　　金：2021年陕西省自然科学基础研究计划项目(No.2021JQ-918)。

摘　　要：目的比较艾司氯胺酮与舒芬太尼用于全身麻醉诱导气管插管中对血流动力学的影响。方法选择2021年5月至12月在我院择期行全身麻醉下气管插管甲状腺手术的60例患者,按照随机数字表法将其以1∶1的比例分为艾司氯胺酮0.5 mg/kg+右美托咪定1.0μg/kg组(KD组)与舒芬太尼0.3μg/kg+右美托咪定1.0μg/kg组(SD组),每组30例。KD组在插管前10 min静脉泵注右美托咪定1.0μg/kg,全身麻醉诱导时给予艾司氯胺酮0.5 mg/kg;SD组以同样方式泵注右美托咪定,全身麻醉诱导时给予舒芬太尼0.3μg/kg。比较两组的麻醉效果。结果右美托咪定输注10 min后(T_(1))至诱导后(T_(2)),KD组的心率(HR)明显低于入室时(T_(0))(P<0.05);T_(1)至气管插管后3 min(T_(4)),SD组的HR明显低于T_(0)(P<0.05);气管插管即刻(T_(3)),KD组的平均动脉压(MAP)明显高于T_(0)(P<0.05);T_(2)~T_(4),SD组的MAP明显低于T_(0)(P<0.05);T_(3)~T_(4),SD组的HR、MAP明显低于KD组(P<0.05)。两组的手术时长和术毕至拔管的苏醒时间无显著差异(P>0.05)。SD组的高血压、心动过速发生率低于KD组,心动过缓发生率高于KD组(P<0.05)。结论相比于艾司氯胺酮,舒芬太尼用于全身麻醉诱导气管插管中的血流动力学指标更平稳,对临床用药有一定的参考价值。Objective To compare the effects of esketamine and sufentanil on hemodynamics of tracheal intubation induced by general anesthesia.Methods From May to December 2021,60 patients undergoing elective thyroid surgery with tracheal intubation under general anesthesia in our hospital were selected and divided into esketamine 0.5 mg/kg+dexmedetomidine 1.0μg/kg group(KD group)and sufentanil 0.3μg/kg+dexmedetomidine 1.0μg/kg group(SD group)in a ratio of 1∶1 according to the random number table method,with 30 cases in each group.In the KD group,dexmedetomidine 1.0μg/kg was intravenously pumped 10 min before intubation,and esketamine 0.5 mg/kg was given during general anesthesia induction;in the SD group,dexmedetomidine was pumped in the same way,and sufentanil 0.3μg/kg was given during general anesthesia induction.The anesthesia effects were compared between the two groups.Results From 10 min after dexmedetomidine infusion(T_(1))to after induction(T_(2)),the heart rate(HR)in the KD group was significantly lower than that at the time of entering the operating room(T_(0))(P<0.05);from T_(1) to 3 min after intubation(T_(4)),the HR in the SD group was significantly lower than that at T_(0)(P<0.05);at the moment of tracheal intubation(T_(3)),the mean arterial pressure(MAP)of the KD group was significantly higher than that at T_(0)(P<0.05);at T_(2)-T_(4),the MAP of the SD group was significantly lower than that at T_(0)(P<0.05);at T_(3)-T_(4),the HR and MAP in the SD group were significantly lower than those in the KD group(P<0.05).There were no significant differences in the operation time and the recovery time from the end of operation to extubation between the two groups(P>0.05).The incidences of hypertension and tachycardia in the SD group were lower than those in the KD group,and the incidence of bradycardia was higher than that in the KD group(P<0.05).Conclusion Compared with esketamine,sufentanil has a more stable hemodynamic index in tracheal intubation induced by general anesthesia,which has a certain reference v

关 键 词：艾司氯胺酮 舒芬太尼 气管插管 血流动力学 

分 类 号：R614[医药卫生—麻醉学]