舒芬太尼复合小剂量芬太尼用于体外循环对血流动力学及应激反应的影响

Influence on hemodynamics and stress response in cardiopulmonary bypass by Sufentanil with small doses of Fentanyl

目的探讨舒芬太尼复合小剂量芬太尼用于体外循环对血流动力学及应激反应的影响。方法选取择期体外循环下行房、室间隔缺损修补术的患儿60例为研究对象,将其随机分为观察组和对照组,每组各30例。观察组予以舒芬太尼1μg/kg和芬太尼5μg/kg、对照组予以芬太尼10μg/kg进行诱导麻醉和维持麻醉,分别观察两组患儿多个时点的血流动力学和应激反应指标。结果麻醉后两组患儿T2-T4大多数时点收缩压（SBP）、舒张压（DBP）、心率（HR）、平均动脉压（MAP）、动脉血氧饱和度（SpO2）与麻醉诱导前比较,差异均有统计学意义（P〈0.05或P〈0.01）。麻醉后观察组T2-T4时点SBP、DBP、HR、MAP变化均较对照组变化显著,差异均有统计学意义（P〈0.05或P〈0.01）。血浆中皮质醇（Cor）和血糖（Glu）在T2、T3、T4时点,观察组均低于对照组水平,差异均有统计学意义（P〈0.05或P〈0.01）。结论舒芬太尼复合小剂量芬太尼用于先天性心脏病患儿手术麻醉时,可稳定患儿的血流动力学、抑制应激反应,有较佳的循环稳定性,更利于手术麻醉。

Objective To explore the influence on hemodynamics and stress response in cardiopulmonary bypass by Sufen tanil with small doses of Fentanyl.Methods 60 children with septal or ventricular septal defect undergoing elective defect repair operation in cardiopulmonary bypass were randomly divided into observation group and control group,30 cases of each group.The patients in the observation group were given Sufentanil（1 μg/kg） with small doses of Fentanyl（5 μg/kg）,and the patients in the control group were given Fentanyl（10 μg/kg） to induce and maintain anesthesia.Then hemodynamics and stess response indicators with multiple points in the two groups were observed.Results SBP,DBP,HR,MAP and SpO2 of T2 to T4 in the two groups changed after anesthesia（P〈0.05 or P〈0.01）,and SBP,DBP,HR,MAP′s changes in above points in the observation group were obvious than those in the control group（P〈0.05 or P〈0.01）.Cor and Glu of T2,T3,T4 in the observation group were lower than those in the control group（P〈0.05 or P〈0.01）.Conclusion It strengthens hemodynamic,inhibits stress response by Sufentanil with small doses of Fentanyl in congenital heart disease ′s operation anesthesia,and it has stabe circulation,so is more suit to the anesthesia.