摘要
目的研究脑电双频指数（BIS）监控下不同剂量舒芬太尼对老年人全麻诱导插管期间循环系统的影响，为临床提供合理的用药依据。方法选择ASAI、Ⅱ级择期全麻下行腹部手术的老年患者60例。将其随机分为三组：舒芬太尼0．2μg／kg组（S1组）、舒芬太尼0.3μg／kg组（s2组）、舒芬太尼0．4μg／kg组（s3组），每组各20例。靶控输注异丙酚维持，各组插管时BIS值为（50±5）。麻醉诱导期间分别在麻醉前（T0）、气管插管前（T1）、插管后即时（T2）、插管后2min（T3）、插管后5min（T4），记录各点SBP、DBP、BIS值、HR，及异丙酚用量。结果三组患者插管前BIS值均维持在（50±5），且差异无显著性（P〉0．05）。T1时间点三组血压均较各组T0时间点显著下降，而三组间比较差异无显著性（P〉0．05），插管后s1组血流动力学波动幅度显著高于S2、S3组，而S3组插管后血流动力学指标变化最小，趋于平稳。结论静脉注射舒芬太尼0．4μg／kg有效地抑制老年患者插管时心血管应激反应，保持循环系统稳定。
Objective To provide reasonable usage of medications by observing the effects of different doses of sufentanil on the circulatory system in elderly patients during induction of general aneasthesia under real-time monitoring of BIS. Methods 60 ASA I and II elderly patients undergoing elective abdominal surgeries were selected and randomly divided into three groups （ 20 for each group ）：. groups with sufentanil of 0.2 μg/kg （ group S1 ）, 0.3 μg/kg （ group S2 ）, and 0.4 μg/kg （ group S3 ）. The BISvalues were （ 50 ±5 ） during intubation and TCI of propofol was maintained. SBP, DBP, BIS values, HR, and dosage of propofol were recorded before aneasthesia （ T0 ） and intubation （ T1 ）, and at the moment of completion of intubation （ T2 ）, 2 rain （ T3 ）, and 5 rain after intubation （ T4 ）. Results Before intubation, BIS values maintained at（ 50 ± 5 ）in all the three groups, with no significant differences. Blood pressure decreased at T1 as compared with TO in all the three groups, and did not differ significantly among the three groups. After intubation, the level of hemodynamic fluctuation was markedly higher in group SI than in group $2 and group S3. The change in hemodynamics was least in group $3. Conclu- sions Intravenous sufentanil of 0.4μg/kg can effectively inhibit cardiovascular stress responses in elderly patients and can keep the circulatory system stable.
出处
《国际医药卫生导报》
2011年第23期2846-2849,共4页
International Medicine and Health Guidance News
基金
惠州市科技计划项目（44011120081643k）
关键词
舒芬太尼
老年人
气管插管
脑电双频指数
心血管反应
Sufentanil
Elderly
Tracheal intubation
Bispectral index
Cardiovascular responses
