舒芬太尼靶控输注在中老年患者气管插管时的应用

The Application of Sufentanil Target Concentration Infusion During Intubation in Middle-age and Elderly Patients

目的探讨气管插管过程中,舒芬太尼用于中老年人的效应室靶控剂量。方法 60例中老年患者,按舒芬太尼效应室靶控浓度随机分为3组:A组0.2μg/L;B组0.4μg/L;C组0.6μg/L。丙泊酚效应室靶控浓度3组均设为3mg/L。记录诱导及气管插管前1min和后4min的心率、平均动脉压和脑电双频谱指数(BIS)值,并记录舒芬太尼用量。结果诱导后3组的心率、平均动脉压及BIS值均发生明显变化,差异与诱导前比较均有统计学意义(P<0.05)。插管后,A组、B组各指标及C组的BIS值变化均有统计学意义(P<0.05),而C组的心率和平均动脉压则无明显变化(P>0.05)。3组舒芬太尼的用量(μg)差异有统计学意义(F=108.68,P<0.01),3组均无严重不良事件发生。结论舒芬太尼效应室靶控浓度0.6μg/L复合丙泊酚效应室靶控浓度3mg/L用于中老年人气管插管时心率、平均动脉压波动最小;舒芬太尼效应室靶控值0.2、0.4、0.6μg/L均能达到满意的镇静深度,对BIS影响相同。

Objective To investigate the optimal effective target concentration of sufentanil during intubation for middle-age and elderly people.Methods Sixty middle-age and elderly patients were randomly divided into 3 groups according to the effective target concentration of sufentanil：A,B,C which were administered respectively 0.2μg/L,0.4μg/L,0.6μg/L.The effective target concentration of propofol is 3 mg/L every group.HR,MAP and bispectrial index（BIS）were recorded before induction and tracheal intubation 1 min and which were recorded during induction and tracheal intubation 4 min,sulfentanyl dosis were recorded too.Results There were statistical significance of HR,MAP,BIS in every grop between preinduction and post-induction.Post tracheal intubation,there were statistical significance except the HR and MAP in group C.Sulfentanyl dosis had statistical difference among there groups（F=108.68,P0.01）,and there were no severe adverse event every group.Conclusion The changes of HR、 MAP and BIS during intubation were more smoothly when the effective target concentration of 0.6μg/L sufentanil combined with 3 mg/L propofol on middle-age and elderly patient undergone lumbar spine surgery.The influence to BIS were identical which effective target concentration of sufentanil was 0.2、0.4、0.6μg/L respectively,and all can calm effectively.