舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响

目的评价舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响。方法选择全麻择期手术成年患者120例,ASAⅠ~Ⅱ级,无明显心血管病史,随机分为两组(n=60),A组:舒芬太尼0.5μg/kg;B组:舒芬太尼0.5μg/kg+艾司洛尔1 mg/kg。观测比较麻醉诱导前、插管后5 m in、拔管后5 m in收缩压(SP)、舒张压(DP)和心率(HR)变化,并采集桡动脉血7m l,测定血浆肾上腺素(Ad)和去甲肾上腺素(NA)的浓度。结果两组年龄、体重、ASA分级、并发症比较差异均无统计学意义(P>0.05)。与A组同一时点比较,B组HR、SP、DP及血浆Ad和NA的浓度降低(P<0.05)。A组插管后HR、SP、DP及血浆Ad和NA的浓度明显高于麻醉诱导前(P<0.05),持续至拔管后5 m in;B组拔管前后变化不明显(P>0.05)。结论舒芬太尼复合艾司洛尔可更好地预防全麻患者气管拔管时的心血管反应。

Effect of Sufentanil and Esmolol on Cardiovascular Response to Extubation after General Anesthesia

Objective To investigate the efficacy of sufentanil and esmolol in the prevention of cardiovascular response to extubation after general anesthesia.Methods A total of 120 ASA I or II patients undergoing selective operation under general anesthesia were randomly divided into two groups(n=60/group).Group A was administered with sufentanil(0.5 μg/kg),and Group B with sufentanil(0.5 μg/kg) and esmolol(1 mg/kg).The parameters of systolic pressure(SP),diastolic pressure(DP),heart rate(HR),and concentrations of plasm adrenaline(Ad) and noradrenaline(NA) were compared between the two groups before induction,5 min after endotracheal intubation and 5 min after extubation.Results There were no significant differences in age,body weight,ASA class and complication between the two groups(P>0.05).SP,DP,HR and the concentrations of Ad and NA were significantly lower in Group B than in Group A(P<0.05).SP,DP,HR and the concentrations of Ad and NA were significantly higher after intubation than before induction in Group A(P<0.05),which lasted until 5 min after extubation,but they were not statistically changed in Group B(P> 0.05).Conclusion The combination of sufentanil and esmolol can better prevent cardiovascular response to extubation after general anesthesia.