摘要
目的探讨靶控输注(TCI)舒芬太尼、依托咪酯对全麻诱导期血流动力学的影响。方法选取2014年6~12月进行择期全麻手术的患者120例,按照麻醉方法分成观察组和对照组各60例,观察组采用靶控输注血浆质量浓度舒芬太尼0.30 ng/ml,联合依托咪酯靶控输注血浆质量浓度0.60μg/ml,对照组采用传统麻醉诱导方法。观察两组麻醉前(T0)、插管前即刻(T1)、插管时(T2)、插管后1 min(T3)、插管后3 min(T4)和插管后5 min(T5)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR)变化。结果两组给药前血压、MAP及HR比较差异无统计学意义(P>0.05);观察组在给药后各时间点的血压、MAP及HR较麻醉前降低,但均在临床安全范围内,其中,T1、T2、T3、T4各时间点均较T0明显降低,差异有统计学意义(P<0.05),而其他时间点间比较则无统计学意义(P>0.05);对照组气管插管和拔管时血压均有明显波动,心率无明显变化。结论靶控输注舒芬太尼、依托咪酯可作为有效的麻醉诱导药物,能够较好地抑制插管引起的应激反应,并且对全麻诱导期血流动力学的影响最小。
Objective To investigate the influence of sufentanil and etomidate by TCI on blood flow dynamics during induction of general anesthesia. Methods 120 patients who underwent selective operation with general anesthesia from June to December,2014 were selected and then divided into observation group and control group with 60 patients in each group based on anesthesia method. Sufentani with plasma concentration of 0. 30 ng / ml combined with etomidate with plasma concentration of 0. 60 μg / ml were given to the observation group by TCI,while anesthesia by traditional induction method was adopted in the control group. Then,systolic blood pressure( SBP),diastolic blood pressure( DBP),mean arterial pressure( MAP) and heart rate( HR) at T0( before anesthesia),T1( before intubation),T2( during intubation),T3( 1 min after intubation),T4( 3min after intubation) and T5( 5 minute after intubation) were observed between groups. Results No statistically significant difference between the two groups were found in blood pressure,MAP and HR before administration( P > 0. 05). Blood pressure,MAP and heart rate in the observation group at each time after administration reduced compared with those before anesthesia,but they were all in the range of clinical safety,and those at T1,T2,T3,T4 reduced more significantly than those at T0,so difference was statistically significant( P < 0. 05),while there was no statistically significant difference at the other time points( P > 0. 05). Blood pressure of the control group obviously fluctuated while intubating and extubating,but no significant changes were found in the HR. Conclusion Both sufentanil and etomidate by TCI can effectively induce anesthesia and restrict stress response caused by intubation tube. Moreover,they have the least influence on blood flow dynamics during induction of general anesthesia.
出处
《右江医学》
2015年第5期586-588,共3页
Chinese Youjiang Medical Journal
