不同剂量舒芬太尼在神经外科手术全麻诱导插管中的应用

[目的]观察不同剂量舒芬太尼在神经外科麻醉诱导插管过程中对血流动力学变化的影响,探讨其合理剂量.[方法]60 例择期ASAⅠ～Ⅱ级行神经外科手术患者,按舒芬太尼的诱导剂量随机分为A组（0.2 μg/kg）、B组（0.5 μg/kg）、C组（1.0 μg/kg）,每组20例.观察3组病人血流动力学变化.[结果]与诱导插管前相比,3组病人的血压及心率均下降（P〈0.05）,A组病人插管时,插管后1 min、3 min血压及心率较插管前有所升高（P〈0.05）,插管后5 min降至插管前水平.B组、C组病人插管前后血压和心率变化不明显.[结论]在神经外科手术全麻诱导插管中0.5 μg/kg和1.0 μg/kg舒芬太尼较0.2 μg/kg能更好地抑制插管反应,但应密切观察窦缓等副反应的发生.

Application of Different Doses of Sufentanil in Tracheal Intubation During Neurosurgery Under General Anesthesia Induction

[Objective]To observe hemodynamic response during tracheal intubation of neurosurgery after general anesthesia induction with different doses of sufentanil, and determine the appropriate dose of sufentanil. [Methods]Sixty patients with ASA Ⅰ-Ⅱ for elective neurosurgery were randomly divided into 3 groups （0.2μg/kg in group A, 0.5μg/kg in group B and 1.0μg/kg in group C, n = 15）. The hemodynamic changes of the three groups were observed. [Results]The blood pressure and heart rate at T1 （ after induction ） were significantly lower than those at To （basic level ）（ P 〈0.05） in all groups. The blood pressure and heart rate at T3 （1 min after intubation） and T4 （3min after induction） were markedly higher than those at T2 （intubation） in group A（ P 〈0.05） and returned to the level of T1 at 5 minutes after intubation. On the contrary, there was no change in group B and group C. [Conclusion] Sufentanil with the dosage of 0. 5μg/kg and 1.0μg/kg can control the stress responses to the tracheal intubation more effectively than that of 0. 2μg/kg, but the side effects such as bradycardia should be observed closely.