靶控输注舒芬太尼复合依托咪酯对诱导期血流动力学影响

Effects on hemodynamics from sufentanil combined with etomidate given by TCI during induction course

目的比较不同靶浓度舒芬太尼复合依托咪酯对诱导期血流动力学的影响。方法60例择期全麻手术患者随机分为三组。首先靶控输注（TCI）依托咪酯浓度依次为0.4、0.5、0.6μg/ml,然后效应室TCI舒芬太尼浓度分别为0.2μg/ml（Ⅰ组）、0.3μg/ml（Ⅱ组）、和0.4μg/ml（Ⅲ组）,记录基础值（T0）,依托咪酯达0.4μg/ml（T1）、0.5μg/ml（T2）、0.6μg/ml（T3）,舒芬太尼靶控浓度平衡后1min（T4）,插管后1min（T5）、3min（T6）、5min（T7）的MAP和HR,BIS。结果Ⅰ组T5~T7时,Ⅱ组和Ⅲ组T5、T6时的BP较T4时增高（P〈0.05）。Ⅰ组T5~T8和Ⅲ组T6~T7时HR均增快（P〈0.05）。结论复合依托咪酯0.6mg/ml输注时,舒芬太尼效应室浓度为0.3mg/ml比较适宜插管。

Objective To compare the effects on hemodynamics from different target concentrations of sufentanil combined with etomidate infused by TCI during induction course.Methods Sixty patients undergoing selective surgery with general anesthesia were randomly divided into three groups with 20 cases each.The etomidate concentrations were separately 0.4,0.5 and 0.6μg/ml at the beginning,was administered by TCI in three steps.Then the concentrations of TCI sufentanil were respectively 0.2,0.3 and 0.4ng/ml for group I,0.3μg/ml group Ⅱand 0.4μg/ml group Ⅲin the effect-site.The BP and HR were recorded before anesthesia（T0）,when the concentrations of etomidate were 0.4μg/ml（T1）,0.5μg/ml（T2）,0.6μg/ml（T3）,the target-controlled concentrations of the sufentanil were 1min（T4）,1min（T5）,3min（T6）and 5min（T7） after being balanced,and intubation in the MAP,HR and BIS.Results BP at T5~T7 in groupⅠand at T5~T6 in groupⅡand group Ⅲ were significantly higher than those at T4（P0.05）.HR at T5~T8 in group I and at T6~T7 in group Ⅲ increased rapidly（P0.05）.Conclusions It is recommended that when the mixtured etomidate should be infused in concentration 0.6mg/ml and that of sufentanil in effect site 0.3ng/ml it is suitable for tracheal intubation.