舒芬太尼在老年手术患者全身麻醉诱导中对血流动力学的影响

目的：探讨舒芬太尼在老年手术患者全身麻醉诱导中对血流动力学的影响。方法：114例接受全麻手术的老年患者随机分为观察组（n=57）与对照组（n=57），观察组采用舒芬太尼诱导麻醉，对照组采用芬太尼诱导麻醉，对比两组麻醉诱导前（t0）、气管插管开始时（t1）、气管插管完成1min（t2）、5min（t3）、10min（t4）五个时点的收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SPO2）等血流动力学指标变化。结果：两组SBP、DBP及HR在t1时点均明显低于t0时点，差异具有统计学意义（P〈0．01）；对照组t2时点SBP、DBP及HR仍维持低水平，且明显低于t0时点，差异具有统计学意义（P〈0．01）；观察组SBP、DBP及HR在t2时点回升，但与t0时点比较，差异无统计学意义（P〉0．05）；两组间t2时点比较，差异具有统计学意义（P〈0．01）；对照组SBP、DBP及HR水平t3、t4时点出现回升，且均明显高于t0时点，差异具有统计学意义（P〈0．01）；两组间t3、t4时点比较，差异具有统计学意义（P〈0．01）。结论：舒芬太尼在老年患者全身麻醉诱导对血流动力学影响较轻，且恢复较快，将有效降低血流动力学不稳定对老年患者造成的不良影响。

Influence of Sufentanil on Hemodynamics in elderly patients for general anesthesia induction

Objective.. To explore the influence of sufentanil anesthesia induction on hemodynamics in elderly patients undergoing surgery. Methods.. A total of 114 elderly patients undergoing surgery were divided into the observation group（n= 57） and control group （n = 57）, the observation group were given sufentanil for anesthesia induction, and the control group were given fentanyl, then SBP, DBP, HR, and SPO2 at five time points including before anesthesia induction （tO）, before trachea cannula insertion（t1 ）, 1 min（t2 ） ,5 min（t3 ）and 10 min（t4 ）after trachea cannula insertion were compared between the two groups. Results..SBP, DBP, and HR at t1 were significantly lower than that at to in both observation and control group （P〈 0.01）. SBP, DBP, and HR at t2 in the control group remained low level, and were significantly lower than that at to （P〈 0.01） SBP, DBP, and HR in the observation group began to rise at t2, but were not significantly different from that at t0 （P〉 0.05） Significant difference in these values at t2 were observed between the two groups （P〈0.01）. SBP, DBP, and HR of the control group rise began to rise at t3, t4, and were all significant higher than that at t0 （P〈0.01）. There was significant difference in SBP, DBP, and HR between the two groups at t3 , t4 （P〉0.05）. Conclusion： Sufentanil shows slight influence on hemodynamics for anesthesia induction in elderly patients undergoing surgery, and can help to promote patients recovery; it can also effectively reduce the adverse effects caused by instability of hemodynamic in elderly patients.