靶控输注不同剂量舒芬太尼复合依托咪酯对高龄患者气管插管反应影响的研究

The effect of target-controlled infusion of sufentanil combined with etomidate on senile patients with tracheal intubation response

目的观察靶控输注不同剂量舒芬太尼复合依托咪酯对高龄患者气管插管反应的影响。方法选择该院2014-05~2015-09收治的需行全身麻醉高龄患者48例作为研究对象,ASA分级Ⅱ~Ⅲ级,按照数字表法分为观察组和对照组两组,每组24例,观察组靶控输注0.35μg/ml舒芬太尼及依托咪酯0.5μg/ml行麻醉诱导,对照组靶控输注0.40μg/ml舒芬太尼及依托咪酯0.5μg/ml行麻醉诱导,比较两组患者诱导时血流动力学变化及不良反应发生率。结果观察组插管后即刻及插管后1 min、3 min、5 min、10 min心率及平均动脉压较对照组更为平稳(P<0.05),两组诱导期脑电双频指数(BIS)值比较差异无统计学意义(P>0.05)。结论靶控输注0.35μg/ml舒芬太尼及依托咪酯0.5μg/ml对高龄患者气管插管反应影响小,患者血流动力学更为稳定,具有重要临床价值。

Objective To observe the effect of target-controlled infusion of different doses of sufentanil combined with etomidate on elderly patients with tracheal intubation response. Methods Forty-eight elderly patients undergoing general anesthesia in our hospital from May 2014 to September 2015 were selected as the research subjects,ASA grade from Ⅱ to grade Ⅲ,and were randomly divided into two groups with 24 cases in each group. The observation group was given target-controlled infusion of sufentanil 0. 35 μg / ml and etomidate 0. 5 μg / ml for anesthesia induction while the control group was given target-controlled infusion of sufentanil 0. 40 μg / ml and etomidate 0. 5 μg / ml for anesthesia induction. The hemodynamic changes and the incidence of adverse reactions were compared at the anesthesia induction. Results According to the result of the analysis,the heart rate and mean arterial pressure in the patients in the observation group were more stable than those in the control group before and after the intubation and 1,3,5 and10 min after the intubation（ P〈0. 05）. There were no significant differences in the values of BIS during the induction period between the two groups（ P〉0. 05）. Conclusion Target-controlled infusion of sufentanil 0. 35 μg / ml and etomidate 0. 5 μg / ml has little effect on the tracheal intubation response in senile patients and has more stable hemodynamics.