舒芬太尼与芬太尼对全麻诱导期血流动力学及应激反应的影响

Effects of Sufentanil and Fentanyl on hemodynamics and stress response during induction of general anesthesia

目的观察舒芬太尼、芬太尼对全麻手术患者诱导期血流动力学及应激反应的影响。方法选择40例全麻手术患者,随机分为两组：舒芬太尼（S）组和芬太尼（F）组,每组各20例；分别记录诱导前（T0）、插管前（T1）、插管即刻（T2）、插管后1 min（T3）、手术开始（T4）的心率（HR）、血压（Bp）、血氧饱和度（SpO2）的变化,并在这几个时点抽取肘静脉血,放免法测定血浆皮质醇（Cor）和血糖（Glu）浓度。结果F组心率（HR）、舒张压（DBp）、收缩压（SBp）在T2～T4各时点明显高于S组（P〈0.05）；F组患者血浆Cor和Glu浓度在T2～T4各时点较S组均明显升高（P〈0.05）。结论与等效剂量的芬太尼比较,舒芬太尼在全麻诱导气管插管过程中能提高麻醉效果,维持血流动力学,抑制了心血管应激反应。

Objective To observe the cileets of Sutentanil and Fentanyl on hemodynamlcs and stress reaction in patients during induction of general anesthesia. Methods Forty patients undergoing general anesthesia operation were randomly divided into 1Lwo groups （ n = 20） ： Sufentanil group （ group S） and Fentani group （group F） , Vital signs, such as HR, BP and SpO2 were observed and recorded before induction （To ）, before intubation, （T~）, at intubation （ T2 ）, 1 min after intubation （ T3 ）, operation began （ T4 ） , and venous blood in the elbow point was extracted, determinating of plasma cortisol immunoassay （Cor） and blood glucose （Glu） concentration by radioimmunoassay. Results HR, DBP and SBP of group S in T2 - T4 was significantly higher than that of group F at any time point （P 〈 0. 05 ） ; Compared with Cor and Glu concentration of group S, that of group F were significantly increased at T2 ～ T4 （P 〈 0. 05）. Conclusions Compared with the equivalent dose of fentanyl, sufentanil during intubation can improve the effects of anesthesia, keep the stable of hemodynamics , inhibit cardiovascular stress reaction.