不同剂量舒芬太尼对老年患者气管插管心血管反应的影响

目的观察不同剂量舒芬太尼对老年患者气管插管时心血管反应的影响，探讨其减轻老年患者气管插管心血管反应的适宜剂量。方法拟行择期结、直肠癌腹腔镜手术；老年患者90例，随机分为舒芬太尼0．1μg／kg组（S1组），舒芬太尼0．2μg／kg组（S2组），舒芬太尼0．3μg／kg组（S3组），每组各30例。监测患者人室静卧后5min（T0，基础值）、插管前1min（T1）、插管后1min（T2）、3min（T3）、5min（T4）各时点患者的收缩压（SBP）、舒张压（DBP）、心率（HR），并在以上各时点抽取上肢静脉血，以高效液相色谱法测定血浆去甲肾上腺素（NE）和肾上腺素（N）水平。结果S1组患者气管插管后血流动力学及血浆去甲肾上腺素（NE）和肾上腺素（N）浓度与插管前比较明显增高，呈一过性；S2组患者患者气管插管后血流动力学及血浆去甲肾上腺素（NE）和。肾上腺素（N）浓度与插管前比较，轻度增高；S3组患者患者气管插管后血流动力学及血浆去甲肾上腺素（NE）和肾上腺素（N）浓度与插管前比较无明显变化。结论气管插管前静脉注射舒芬太尼0．3μg／kg能减轻气管插管引起的应激反应，用于老年患者可能有利于减少气管插管引起的心脑血管意外的发生。

Effects of different dosage sulfentanyl on stress reaction during tracheal intubation in elderly patients

Objective To observe the effects of different dosage sulfentanyl on stress reaction during tracheal intubation in elderly patients and response induced by intubation in elderly patients investigate it＇s appropriate dose to depress stress Methods Ninty ASA Ⅱ - Ⅲ patients undergoing elective surgery for colon cancer or rectum cancer were enrolled in this study. The patients were divided randomly into three groups S1 （sulfentanyl 0.1 μg/kg）,S2 （sulfentanyl 0.2 μg/kg）,S3 （sulfentanyl 0.3 μg/kg）. SBP, DBP, HR were recorded at entering operating room（T0）, 1 min before tracheal intubation （T1）, and after tracheal intubation at 1 rain （T2）, at 3min （T3） and at 5 min （T4）. The plasma concentration of NE and E were measured at T0,TI,T2,T3,T4. Results In the change of hemodynamic and NE,E of group Sl,the intracheal post-intubation was higher than that tracheal pre-intubation. While the data in S2 group had a slight increase and the data in S3 group had no significant difference. Conclusion Administered sulfentanyl 0.3μg/kg intraveniously could depress the stress reaction induced by tracheal intubation and might decrease the incidence of heart and brain complication during tracheal intubation in elderly patients.