不同剂量舒芬太尼气管插管时对听觉诱发电位指数及血流动力学的影响

Effects of different doses of sufentanil on auditory evoked potential index and hemodynamics during the tracheal intubation

目的探讨适合于全麻气管插管时舒芬太尼的剂量。方法入选的90例ASAⅠ～Ⅱ级、25～45岁患者,随机分为三组(n=30):舒芬太尼剂量为0.2μg/kg(A组);剂量为0.3μg/kg(B组);剂量为0.35μg/kg(C组),静脉丙泊酚血浆靶浓度为3μg/mL,行OAA/S评分。待OAA/S评分达到3分时给予维库溴胺和舒芬太尼,观察气管插管前后三组的听觉诱发电位指数(AAI)值和血流动力学变化。结果与T0相比,三组在T1、T2时的AAI值均降低(P<0.01),C组在T1、T2时HR值、SpO2值均低于A组和B组(P<0.01),A组在T2时MAP值均高于B组和C组(P<0.01)。结论当异丙酚靶控在3μg/mL,0.3μg/kg剂量的舒芬太尼在全麻气管插管时是安全合适的。

Objective To investigate the appropriate dose of sufentanil in patients during the tracheal incubation. Methods Ninety adult patients of American Society of Anesthesiologists physical status I or 11 （ASA I or II ）, aged 25-45 years,were included in this study. They were randomly divided into 3 groups,each group had 30 cases,according to the different in duction doses of sufentanil： sufentanil 0.2 μg/kg group （group A）, sufentanil 0.3 μg/kg group （group B）, sufentanil 0.35 μg/kg group（group C）. All patients were induced with TCI of propofol（target plasma concentration set at 3.0 μg/mL）. At the time of propofol achieving the target plasma concentration of 3.0 μg/mL,Observer＇s assessment of alertness/sedation （OAA/S） was measured. When OAA/S reached 3 scores,vecuronium and sufentanil were administrated with IV of 0.2,0.3,0.35 μg/kg. Mean arterial pressure （MAP）, heart rate （HR）,oxygen saturation of pulse oximeter （SpO2） and auditory evoked potential index（AAI） were recorded at immediately after injection of sufentanil（T0）, pre traceal intubation（T1）, endotracheal intuba- tion（T2） using Intellivue MP50 monitor and EEG monitoring device. Results The valus of AAI at T1 ,T2 were significantly lower than that at To in three groups. The valus of HR,SpO2 at TI ,T2 in group C were significantly lower than those in group B and group A （P 〈 0.01 ） ;The valus of MAP at T2 in group A were significantly increased than those in group B and group C（P 〈 0.01 ）. Conclusion Sufentanil 0.3 μg/kg（group B） is the suitable dose of choice during the tracheal in- cubation when combined with propofol TCI with Cp set at 3.0 μg/mL in patients and hemodynamics is stable.