舒芬太尼或芬太尼复合硝酸异山梨酯预防老年高血压患者气管插管反应

目的观察舒芬太尼或芬太尼复合硝酸异山梨酯对老年高血压患者全麻诱导期应激反应的影响。方法选择20例60～70岁拟于全身麻醉下行手术治疗的患者,随机分为实验组：舒芬太尼组（I）和对照组：芬太尼组（II）。两组患者在麻醉诱导时分别应用舒芬太尼和硝酸异山梨酯或芬太尼和硝酸异山梨酯,观察两组患者诱导前（T0）、插管前（T1）、插管后即刻（T2）以及插管后5min（T3）、10min（T4）时点的收缩压（DBP）、舒张压（SBP）、心率（HR）值以及血浆中去甲肾上腺素（NE）、心钠素（ANP）的浓度。结果与诱导前（T0）相比,两组患者插管后即刻（T2）血压无明显变化。舒芬太尼组（I）,插管后5min（T3）、10min（T4）血压低于T0点,插管后即刻（T2）及5min（T3）,舒芬太尼组（I）血压低于芬太尼组（II）。与插管前（T1）比较,两组患者插管后即刻（T2）心率均升高。舒芬太尼组（I）,插管后即可（T2）及5min（T3）,血浆中去甲肾上腺素浓度均低于芬太尼组。两组比较,血浆心钠素浓度无差别。结论舒芬太尼组和芬太尼组均能有效抑制诱导期应激反应,舒芬太尼组更有效。

Effects of sufentanil and isosorbide dinitrate or fentanil and isosorbide dinitrate on the stress response to general anesthesia of hypertension geriatric tracheal intubation

Objective To study the effect of sufentanil and isosorbide dinitrate or fentanil and isosorbide dinitrate on the stress response to the hypertension patients tracheal intubation during induction of general anesthesia.Methods 20 cases of geratic patients with hypertention operated under general anesthesia were divided into two groups：sufentanil and isosorbide dinitrate group or fentanil and isosorbide dinitrate group.During the anesthesia induction,the two groups were given sufentanil and isosorbide dinitrate or fentanyl and isosorbide dinitrate respectively.Observations were made on Systolic Blood Pressure（SBP）,Diastolic Blood Pressure（DBP）,Heart Rate（HR）,the concentration of norepinephrine（NE） and atrial natriuretic peptide（ANP） of patients in the two groups at before induction,immediately after induction and 5、10 minutes after intubation.Results The SBP and DBP immediately after tracheal intubation and 5 minutes after intubation in the sufentanil group were significantly lower than those in the fentanyl group.There were also significant differences in NE of the patients in the two groups at immediately after induction and 5 minutes after intubation.There were no significant differences in ANP of the patients in the two groups.Conclusion It is more effective to apply sufentanil to the anesthesia induction of elderly patients with hypertension to inhibit stress response during tracheal intubation.