舒芬太尼联合丙泊酚全麻诱导对气管插管时血流动力学的影响

The effect of sufentanil in combination with propofol as general anesthesia induction on hemodynamics during tracheal intubation period

目的：观察舒芬太尼联合丙泊酚对全麻诱导气管插管时血流动力学的影响。方法：选择ASAⅠ-Ⅱ级腹腔镜胆囊切除术患者40例,随机分为舒芬太尼组和芬太尼组,各20例。全麻诱导分别静注咪达唑仑0.05 mg/kg、丙泊酚1-1.5 mg/kg、舒芬太尼0.5μg/kg或芬太尼3-5μg/kg、维库溴铵0.1 mg/kg,5 min后行气管插管。记录并分析诱导前、诱导后、插管后5 min的心血管反应数据。结果：芬太尼组诱导后平均动脉压、心率与诱导前比较,差异有统计学意义（P〈0.01）,而舒芬太尼组与诱导前差异均无统计学意义（P〉0.05）;两组间插管后5 min的平均动脉压、心率差异有统计学意义（P〈0.01）。结论：舒芬太尼联合丙泊酚用于全麻诱导时血流动力学更稳定,应激反应较弱。

Objective： To evaluate the effect of sufentanil in combination with propofol as general anesthesia induction on the hemodynamic response during tracheal intubation period. Methods： Forty patients with ASA Ⅰ - Ⅱ stages laparoscopic cholecystectomy were randomized into 2 groups, sufentanil group and fentanyl group, 20 cases of each group. Anesthesia induction were done through intravenous injection with midazolam at 0.05 mg/kg, propofol at 1 - 1.5 mg/kg, sufentanil at 0.5 μg/kg or fentanyl at 3 - 5 μg/kg, vecuronium at 0.1 mg/kg. Five minutes later, tracheal intubation was done. The hemodynamics before induction, during induction and 5 min after intubation were recorded. Results：In fentanyl group, in contrast to before induction, mean arterial pressure（MAP） and heart rate （ HR ） had more significant differences after anesthesia induction （ P 〈 0. 01 ）. In Sufentanil group, these parameters had no significant difference （ P 〉 0.05 ）. Between the two groups within 5 min after intubation, MAP and HR had significant differences （ P 〈 0.01 ）. Conclusions ： Sufentanil in combination with propofol as general anesthesia induction is more stable and less stress response on blood hemodynamics.