李民,蔡宏伟,陈雪华
LI Min1,CAI Hongwei2,CHEN Xuehua1(1.Department of Anaesthesiology

• 1:北京潞河医院麻醉科
• 2:湘雅医院麻醉科

摘要(Abstract)：

目的:通过对舒芬太尼在全身麻醉诱导中的应用,评价其对插管时应急反应的抑制效果。方法:选择拟行腹腔镜手术的患者60例,随机分为舒芬太尼组(S组)和芬太尼组(F组);两组患者给予咪达唑仑后,S组以舒芬太尼静注,F组以芬太尼静注,然后均给予依托咪酯及罗库溴铵;记录诱导各时点的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR),由同一麻醉医生插管后评价插管条件。结果:(1)在给予芬太尼或舒芬太尼后,SBP、DBP、MAP及HR均较诱导前明显下降(P<0.01),S组SBP、MAP较F组下降明显(P<0.05);在插管后即刻,除HR(P<0.05)外,两组间差异无统计学意义(P>0.05);在插管后2、4min,F组HR高于插管前(P<0.05),S组上述指标与插管前比较P>0.05;(2)S组插管条件评分为优秀者多于F组(P<0.05)。结论:舒芬太尼在全射麻醉诱导中应用,可以使插管前后的血流动力学更加平稳,插管条件更好。
Objective:To evaluate inhibitory effects of sufentanil on stress reaction during general anaesthesia induction. Methods:Sixty patients scheduled for laparoscopic operation were randomly divided into sufentainil group(group S,n=30) and fentanyl group (group F,n=30). After all the patients were given midazolam IV,patients of groups S and F were slowly injected with sufentanil or fentanyl respectively,followed by administering etomidate and rocuronium. At each time point of induction,the haemodynamic variables were recorded; Intubating conditions were graded by the same anaesthetist. Results:(1)Systolic blood pressure (SBP),diastolic blood pressure (DBP),mean arterial pressure (MAP),and hart rate (HR) of patients in group F and group S significantly decreased after injection of fentanyl or sufentanyl (P<0.05,P<0.01),and the decreases of SBP,and MAP were more obvious (P<0.01) in group S than in group F;There was no difference in observed indexes between the two groups immediately after intubation (P>0.05) except HR (P<0.05),which increased in 2 and 4 minuts after intubation than before in group F. All the indexes in group S didn't change significantly before and after intubation; (2)There were more cases graded excellent in group S than in group F (P<0.05).Conclusion:Application of sufentanil causes more stable hemodynamics and better intubating conditions.

关键词(KeyWords)： 舒芬太尼;麻醉,静脉;插管法,气管内;血流动力学
sufentanil; anesthesia,intravenous; intubation,intratracheal; hemodynamics

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李民,蔡宏伟,陈雪华
LI Min1,CAI Hongwei2,CHEN Xuehua1(1.Department of Anaesthesiology

DOI: 10.19367/j.cnki.1000-2707.2010.03.017

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