摘要
目的:观察不同浓度舒芬太尼对高血压患者全麻诱导期应激反应的影响。方法:全麻高血压患者60例,术前控制血压在一定范围内1周,随机均分为S1、S2、S3 3组,舒芬太尼血浆靶浓度分别为0.2、0.4和0.6 ng/ml。比较麻醉诱导各时段的血流动力学、脑电双频谱指数(BIS)、血浆肾上腺素(E)及去甲肾上腺素(NE)浓度。结果:3组平均动脉压(MAP)、心率(HR)与T0比较,S2组和S3组在T1时刻MAP、HR均下降(P<0.05～P<0.01);S1组在T2、T3、T4时刻MAP、HR均明显升高(P<0.01),S3组在T3、T4时刻MAP、HR均明显降低(P<0.01)。BIS与T0比较,3组在各时间点BIS值均降低(P<0.01),其中S2组在T1、T2、T3、T4时刻变化范围在45～55之间,S1组在T1、T2、T3、T4时刻变化范围高于55,显示麻醉过浅,而S3组在各时点均低于45,显示麻醉过深。S2组插管后各时点血浆E、NE浓度差异均无统计学意义,S3组T2、T3时血浆E浓度低于S1组(P<0.05～P<0.01)。结论:舒芬太尼靶控输注血浆靶浓度为0.4 ng/ml,能明显减轻高血压患者全麻诱导应激反应。
Objective：To study the effect of different target concentrations of sufentanil on the stress response to the hypertension patients tracheal intubation during induction of general anesthesia.Methods：Sixty hypertension patients were randomly divided into three groups with 20 cases each.Each group received a sufentanil target concentration（STC） of 0.2 ng/ml（S1）,0.4 ng/ml（S2） and 0.6 ng/ml（S3）,respectively.Mean arterial pressure（MAP）,heart rate（HR）,and bispectral index（BIS） were recorded at the time points of record baseline（T0）,immediately before intubation（T1）,immediately after intubation（T2）,1 min after intubation（T3）,3 min after intubation（T4）.Results：Compared to T0 point,Map and HR of S2 and S3 were decreased（P0.05-P0.01）;MAP and HR of S2 were all significant increased at T2,T3,T4 point（P0.01）,and of S3 at T3,T4 were signicantly decreased.Compared with T0 point,BIS value of three groups were all decresed（P0.01）,in which were in 45-55 range at T1,T2,T3,T4 of S2.BIS value of S1 were higher than 55 and of S3 were lower than 45,indicating too shallow or deep anesthesia.Comparison of norepinephrine（NE） concentration：T0 compared,S1,S2,S3 at each time point was no significant difference（P0.05）.Comparison with epinephrine（E） concentration：compared with T0,T3 of S1 was higher（P0.05）.T3,T4 of S3 were always lower than S1（P0.05-P0.01）,the difference was statistically significant.Conclusions：The hemodynamic response to the hypertension patients during induction of general anesthesia is stable as the target concentration of 0.4 ng/ml.
出处
《蚌埠医学院学报》
CAS
2011年第9期945-948,共4页
Journal of Bengbu Medical College
关键词
高血压
舒芬太尼
应激反应
麻醉
全身
hypertension
sufentanil
stress response
anesthesiology
general
