舒芬太尼对高血压患者全麻诱导应激反应的影响

目的: 观察不同浓度舒芬太尼对高血压患者全麻诱导期应激反应的影响。方法: 全麻高血压患者60例,术前控制血压在一定范围内1周,随机均分为S1、S2、S3 3组,舒芬太尼血浆靶浓度分别为0.2、0.4和0.6 ng/ml。比较麻醉诱导各时段的血流动力学、脑电双频谱指数(BIS)、血浆肾上腺素(E)及去甲肾上腺素(NE)浓度。结果: 3组平均动脉压(MAP)、心率(HR)与T₀比较,S2组和S3组在T₁时刻MAP、HR均下降(P < 0.05~P < 0.01);S1组在T₂、T₃、T₄时刻MAP、HR均明显升高(P <0.01),S3组在T₃、T₄时刻MAP、HR均明显降低(P < 0.01)。BIS与T₀比较,3组在各时间点BIS值均降低(P < 0.01),其中S2组在T₁、T₂、T₃、T₄时刻变化范围在45~55之间,S1组在T₁、T₂、T₃、T₄时刻变化范围高于55,显示麻醉过浅,而S3组在各时点均低于45,显示麻醉过深。S2组插管后各时点血浆E、NE浓度差异均无统计学意义,S3组T₂、T₃时血浆E浓度低于S1组(P < 0.05~P < 0.01)。结论: 舒芬太尼靶控输注血浆靶浓度为0.4 ng/ml,能明显减轻高血压患者全麻诱导应激反应。

Effects of different target concentrations of sufentanil on the stress response to general anestbesia of hypertension patients tracheal intubation

Objective:To study the effect of different target concentrations of sufentanil on the stress response to the hypertension patients tracheal intubation during induction of general anesthesia.Methods:Sixty hypertension patients were randomly divided into three groups with 20 cases each.Each group received a sufentanil target concentration(STC) of 0.2 ng/ml(S1),0.4 ng/ml(S2) and 0.6 ng/ml(S3),respectively.Mean arterial pressure(MAP),heart rate(HR),and bispectral index(BIS) were recorded at the time points of r...