摘要
目的 观察不同剂量舒芬太尼联合右美托咪定对小儿全身麻醉诱导插管时血流动力学及脑电双频指数（BIS）变化的影响。方法 以2015-11-2016-11于气管插管全麻下行腹腔镜阑尾手术的45例患儿为研究对象，将患儿随机分为Ⅰ、Ⅱ、Ⅲ组，在给予相同剂量右美托咪定的基础上，各组对应的舒芬太尼剂量为0.2、0.3、0.4 μg/kg。记录患儿入室后（T0）、麻醉诱导后（T1）、气管插管即刻（T2）、气管插管5 min（T3）的BP、HR和BIS值。并记录出现心动过缓病例数及插管期间产生的不良反应。记录患儿麻醉诱导后心率较诱导前下降超过30次/min的病例数，记录拔管时间、麻醉苏醒时间、恢复室滞留时间、躁动评分及麻醉苏醒期间的不良反应。结果 与T0比较，T1各组的BP、HR、BIS的显著降低（P〈0.05）；Ⅰ组患儿，插管即刻（T2）的BP、HR均较诱导后升高（T1）（P〈0.05）；Ⅲ组患儿，T2，T3时刻的BP、HR较T0时刻降低；组间比较，Ⅰ组患儿与Ⅲ组患儿比较，T2、T3的BP、HR相对较高。三组间各时点的BIS变化比较差异无统计学意义（P〉0.05）。Ⅲ组患儿有3例出现心动过缓，2例患儿心率下降超过30次/min。结论 0.3 μg/kg 的舒芬太尼对患儿BP、HR的影响相对不明显，使用该剂量进行小儿麻醉诱导更合理。
Objective To investigate the relationship of different dose of sufentanil on hemodynamics and bispectral index during anesthesia induction and intubation in children. Methods Forty -five children scheduled for selective surgery under general anesthesia were randomly divided into three groups with 15 cases from November 2015 to November 2016. The surgery was laparoscopic appendix operation. Patients were given the same dose of dexmedetomidine, while the doses of sufentanil were 0.2 μg/kg （ group Ⅰ ）, 0.3 μg/kg （ group Ⅱ ）, 0.4 μg/kg （ groupⅢ）. BP, HR and BIS were recorded before and after induction. We accordingly recorded these data： the occurrence of adverse reactions and bradycardia during endotracheal intubation, the cases of children＇ heart rate fell by more than 30 times/rain compared with that before induction, the time of extubation and wake up duration of anesthesia recovery room after surgery, the adverse reactions during the waking time and agitation score. Results The BP, HR and BIS of T1 have statistical significance to TO （P 〈 0. 05）. The blood pressure and heart rate of T2 were higher than T1 in group Ⅰ （P 〈 0.05） ; the blood pressure and heart rate of T2 and T3 were still lower than To in group Ⅲ ; the blood pressure and heart rate of T2, T3 in group Ⅲ were lower than group Ⅰ. There were no significant changes in BIS in three groups during anesthesia induction. 3 cases appeared bradycardia, 2 cases＇ heart rate were lower than 30 times/min in group Ⅲ. Conclusion Sufentanil 0.3 μg/kg for induction of anaesthesia in children can effectively depress the cardiovascular response to intubation.
作者
冯丽芝
肖昌武
刘娇
王璐
谢文杰
Feng Li - zhi;Xiao Chang - wu;Liu Jiao;Wang Lu;Xie Wen - jie(Intensive Care Unit, Renmin Hospital of Wuhan University, Wuhan 430060, Chin)
出处
《中国急救医学》
CAS
CSCD
北大核心
2018年第4期337-340,共4页
Chinese Journal of Critical Care Medicine
