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舒芬太尼复合七氟醚用于老年患者麻醉诱导的临床观察 被引量：3

Clinical observation of the sufentanil combined with sevoflurane for anesthesia induction in the elderly
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摘要 目的观察舒芬太尼复合七氟醚用于老年患者麻醉诱导时的临床效果。方法选择择期行腹部手术患者84例，根据七氟醚麻醉诱导时舒芬太尼不同用量，随机分为4组，A组舒芬太尼剂量为0．25μg／kg，B组0．05μg／kg，C组0．75μg／kg，D组1．00μg／kg，每组21例。记录患者进入手术室后10min（T0）、插管前即刻（T1）、插管后即刻（T2）、插管后1min（Ts）、3min（Tt）、5rain（Ts）的平均动脉压（MAP）和心率，并对各组的插管条件进行评分。结果拔管后10min、30min、60min视觉模拟评分（VAs）A组分别为（4．2±0．9、3．5±0．7、4．2±0．4）分，B组分别为（4．0±0．4、3．2±0．8、3．8±0．7）分，c组分别为（3．4±1．0、1．7±1．4、2．6±0．6）分，D组分别为（2．7±0．2、1．9±0．4、1．7±0．8）分；Ramsay评分A组分别为（1．4±1.1、0．8±0．1、2．8±0．1）分，B组分别为（2．2±2．3、1．3±0．4、2．2±0．2）分，C组分别为（2．8±1．7、1．9±0．1、2．0±0．1）分，D组分别为（3．7±2．0、2．4±0．6、2．9±0．1）分；4组患者拔管后各时点，VAS和Ramsay评分为D组〉C组〉B组〉A组（F=5．78，P〈0．05）。T0、T1、T2、T3、T4、T5时点平均动脉压（MAP）A组分别为（93．8±8．1、82．1±4．3、92．8±5．9、90．1±4．8、85．3±4．2、78．0±3．5）mmHg，B组分别为（91．8±6．8、83．4±4．5、87．2±5．1、84．2±5．2、85．6±2．8、84．4±3．6）mmHg，C组分别为（92．8±5．2、82．1±6．0、80．1±4．2、78．0±2．9、75．4±3．3、65．4±5．2）mmHg，D组分别为（88．5±6．3、75．9±4．5、80．1±2．8、76．1±2．3、69．3土3．8、68．9±4．9）mmHg；心率A组分别为（74．2±2．3、68．8±4．9、82．4±4．2、86．4±3．7、80．2±5．1、67．2±4．7）次／min，B组分别为（75．6±1．2、63．8±5．9、78．2±3．9、79．3±5．6、76．3±6．7、64．8±3．9）次／min，C组分别为（76．7±6．1、65．5±5．6、80．4±5．1、76．5±4．3、78．7±3．1、66．1±4．8）次／min，D组分别为（77．5±5．8、75．0±3．8、63．4±5．1、78．8±3．9、79．1土2．5、62．8±4．3）次／min；T1与T0比较，4组MAP下降、HR减慢（F=34．99，P〈0．05），T2时A组MAP升高（F=12．48，P〈0．05）。与A组比较，T4、T5时C、D组MAP下降（F=6．98，6．25，均P〈0．05）；与B组比较，T2～T3时C、D组MAP下降（F=7．08，20．56，均P〈0．05）。结论舒芬太尼0．25～0．50μg／kg复合七氟醚用于老年患者手术麻醉诱导，能提供较好的插管条件和稳定的血流动力学。 Objective To observe the clinical effects of sufentanil combined with sevoflurane for anesthesia induction in the elderly. Methods A total of 84 patients undergoing elective laparoscopic were randomly divided into 4 groups by dose of Sufentanil （ 21 eases, each） 0.25, 0.50, 0.75 and 1.00 μg/kg sufentanil. Mean arterial pressure （MAP）and heart rate （HR）were measured at baseline （To）, immediately before intubation（T1）, immediately, 1, 3 and 5 min after intubation （T2-5）. Intubation scores were also recorded. Results The intubation scores including visual analogue score （VAS） and Ramsay score at 10 min, 30 min and 60 min after tube drawing were as the following sequence： 1.0 μg/kg ：〉0.75 μg/kg ：〉0.5μg/kg ~0.25 txg/kg sufentanil （F= 5.78,P^0.05）. Compared with TO, MAP and HR decreased in each group at T1, while increased at T2 in group A （P d0.05）. As compared with TO, MAP was decreased and HR was slower at T1 in the 4 groups （F= 34.99,P^0.05）, but MAP level was increased in 0.25 /~g/kg sufentanil group at T2 （F= 12.48,P~ 0.05）. Compared with group of 0.25 ~g/kg sufentanil, MAP was reduced in 0.75μg/kg and 1.00 gg/ kg groups at T4 and T5 （F=6.98,6.25,P^0.05）. MAP was also lower in 0.75 μg/kg and 1.00 μg/ kg groups than in 0.50/xg/kg sufentanil group at T2-TS（F=7.08,20.56,P-0.05）. Conclusions Sufentanil of 0.25 0.50 μg/kg combined with sevoflurane can provide excellent intubating conditions and stable hemodynamics during anesthesia induction in patients undergoing gynecologic surgery.
作者 王之成 潘中心 江秀清
机构地区 浙江省衢州市人民医院麻醉科
出处 《中华老年医学杂志》 CAS CSCD 北大核心 2012年第10期854-856,共3页 Chinese Journal of Geriatrics
关键词 舒芬太尼 异氟醚 麻醉药 全身 Sufentanil Sevoflurane Anesthetics, general
分类号 R614 [医药卫生—麻醉学]
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中华老年医学杂志
2012年 第10期

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