摘要
【目的】比较靶控输注不同剂量舒芬太尼复合异丙酚抑制气管插管应激反应的效果。【方法】60例择期上腹部手术患者,ASAⅠ～Ⅱ级,随机分为3组(n=20),全麻诱导时,A组、B组、C组分别靶控输注效应室浓度为0.3、0.5、0.7ng/mL的舒芬太尼2min后,均输注效应室靶浓度为4μg/mL的异丙酚,病人意识消失后给予维库溴铵行气管插管。记录全麻诱导前1min(T1)、气管插管后1min(T2)、3min(T3)、10min(T4)各时点平均动脉压(MAP)、心率(HR);并于T1、T2、T4时点采集桡动脉血,测定血浆肾上腺素(AD)和去甲肾上腺素(NA)浓度。【结果】(1)A组T2时点MAP、HR比T1时点明显升高(P<0.05),C组T2、T3、T4时点MAP明显低于A组(P<0.05),C组T2、T3时点HR明显低于A组(P<0.05),C组T3、T4时点MAP低于B组(P<0.05);(2)A组T2时点血浆AD和NA浓度较T1时点明显升高(P<0.05)、较B组高(P<0.05)、较C组高(P<0.05)。【结论】靶控输注舒芬太尼复合异丙酚可以有效抑制气管插管应激反应,其中舒芬太尼效应室浓度0.5ng/mL复合异丙酚效应室浓度4μg/mL靶控输注的效果较好。
[ Objective.] To compare the effect of target controlled infusion propofol with different concentration of snfentanil on peri-intubation cardiovascular response. [Methods] Sixty ASA （American Society of Anesthesiologists） Ⅰ or Ⅱ patients scheduled for upper abdominal surgery were randomly assigned to 3 groups （n = 20 each）. At induction, sufentanil was administered IV as an effect-site target controlled infusion of group A 0.3 ng/ mL, group B 0.5 ng/mL, group C 0.7 ng/mL, and after two minutes infusion of sufentanil, propofol target controlled infusion was started with an effect-site target concentration of 4 μg/mL. And after patients loss of consciousness, vecuronium 0.1 mg/kg were given IV to facilitate orotracheal intubation. The mean blood pressure （MAP） and heart rate （HR） at the time points of 1 min pre-induction （TI）, 1 min （T2）, 3 rain （T3）, and 10min （T4） after intubation were recorded. And radial artery blood was collected to test the concentration of adrenaline （AD） and noradrenaline （NA） at T1 ,T2 ,T4. [Results] （1） MAP and HR of group A at T2 were obviously higher than that at T1 （P〈 0.05） and MAP of group C were obviously lower than group A at T2, T3, and T4 （P〈 0.05）, HR of group C were obviously slower than group A at T2 and T3 （P〈 0.05）, MAP of group C were lower than group B at T3 and T4 （P〈 0.05）. （2） concentration of AD and NA of group A at T2 were obviously higher than that at T1 （P〈 0.05） and higher than those of group B （P〈 0.05） and group C （P〈 0.05）. [Conclusions]Target controlled infusion sufentanil combined with propofol can effectively inhibit peri-intubation cardiovascular response, and the sufentanil effect-site target concentration of 0.5 ng/mL combined with propofol effect-site target concentration of 4μg/mL will be better.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2007年第4期462-465,共4页
Journal of Sun Yat-Sen University:Medical Sciences
关键词
靶控输注
舒芬太尼
二异丙酚
插管法
气管内
心血管反应
target-controlled-infusion
sufentanil
propofol
intubation, intratracheal
cardiovascular response
