小剂量芬太尼和舒芬太尼对全麻诱导喉罩置入时心血管反应的影响

目的比较运用小剂量芬太尼和舒芬太尼时全麻诱导患者喉罩置入时的心血管反应。方法择期行下腹部或下肢手术的患者40例，随机分为芬太尼组（F组）和舒芬太尼组（S组）。麻醉诱导分别采用静脉注射异丙酚2mg／kg，罗库溴铵0．6mg／kg，F组给予芬太尼2μg/kg，S组给予舒芬太尼0．25μg/kg，诱导完成后置入喉罩。分别记录麻醉前（T0）、诱导完毕（T1）、喉罩置入即刻（1、2）、喉罩置入后1min（T3）、2min（T4）、3min（T5）、4min（T6）和5min（T7）时患者的血压和心率，并观察有无相关的不良反应及并发症。结果从麻醉诱导后到置入喉罩后5min，两组患者心率变化差异无统计学意义（P〉0．05）。与T0相比，F组在T1、T2和T3时间点心率下降，差异有统计学意义（P〈0．05）；S组在T1和T2时间点心率下降，差异有统计学意义（P〈0．05）。两组心动过缓的发生率差异无统计学意义。从麻醉诱导前到喉罩置入后5min，两组间各时间段收缩压（SAP）、舒张压（DAP）、平均动脉压（MAP）的变化差异无统计学意义（P〉0．05）。与110比较，两组患者在观察期的不同时间点出现SAP、DAP、MAP下降，差异有统计学意义（P〈0．05）。结论小剂量芬太尼和舒芬太尼进行全麻诱导喉罩置入时，两者均有效抑制了喉罩置入时的心血管反应，为喉罩置入提供了良好条件。

Effect of low-dosage fentanyl and sufentanil on cardiovascular response to laryngeal mask airway insertion during general anesthesia induction

Objective To compare the cardiovascular response of fentanyl and sufentanil on laryngeal mask airway insertion during general anesthesia induction. Methods Forty patients undergoing low-abdomen or lowextremity procedures were randomly divided into group F or group S. Anesthesia of all patients was induced with propofol （ 2 mg/kg） and rocuronium （ 0. 6 mg/kg）. Fentanyl （ 2μg/kg） was used in group F and sufentanil （ 0. 25μg/kg） was used in group S. Laryngeal mask airway insertion was performed after establishment of neuromuscular blockade. Arterial blood pressure and heat rate were measured at 1 min intervals from 3 min before induction until 5 min after insertion. Results There was no significant difference in heart rate between 2 groups from induction to 5 min after laryngeal airway mask insertion. Compared with T0, heart rate at T1, T2 and T3 was significant lower in group F（P 〈0. 05）. Compared with T0, heart rate at T1 and T2 was significant lower in group S （ P 〈0. 05 ）. Blood pressure had no significant difference between two groups （ P 〉 0. 05 ）. Systolic arterial pressure, diastolic arterial pressure and mean arterial blood pressure decreased significantly at some time points during experimental periods in both groups （ P 〈 O. 05 ）. After laryngeal mask airway insertion, arterial pressure didn＇ t increase above baseline values in either group. Conclusion Low-dosage fentanyl as well as sufentanil provided optimal laryngeal airway mask insertion condition and inhibited cardiovascular re- sponse during general anesthesia induction.