舒芬太尼复合丙泊酚对高血压脑出血手术患者血流动力学的影响

Influence by sufentanil combined with propofol on hemodynamics of patients in hypertensive cerebral hemorrhage operation

目的观察舒芬太尼复合丙泊酚对高血压脑出血手术患者血流动力学的影响。方法 30例择期行高血压脑出血手术患者作为研究对象,采取数字随机法将其分为观察组与对照组,各15例。观察组患者给予舒芬太尼复合丙泊酚进行全凭静脉全身麻醉,对照组患者给予芬太尼复合丙泊酚进行全凭静脉全身麻醉处理,观察两组患者血流动力学变化、麻醉效果与不良反应发生情况。结果观察组在整个围麻醉期的血流动力学指标较平稳,而对照组的血流动力学各指标变化波动较大。两组用药前(T0)各血流动力学指标比较差异无统计学意义(P>0.05);两组麻醉诱导后(T1)、气管插管后5 min(T2)、术中60 min(T3)、术毕带管自主呼吸时(T4)各血流动力学指标比较差异有统计学意义(P<0.05)。观察组的睁眼时间、拔管时间、起效时间、恢复时间明显短于对照组,观察组的镇痛药使用时间明显长于对照组,两组比较差异均有统计学意义(P<0.05)。观察组不良反应发生率为20.0%,高于对照组的6.7%,但差异无统计学意义(P>0.05)。结论对于高血压脑出血手术患者,给予其舒芬太尼复合丙泊酚麻醉,可较好的稳定患者血流动力学,效果显著,值得推广。

Objective To observe influence by sufentanil combined with propofol on hemodynamics of patients in hypertensive cerebral hemorrhage operation.Methods A total of30patients receiving hypertensive cerebral hemorrhage operation as study subjects were divided by random number method into observation group and control group,with15cases in each group.The observation group received sufentanil combined with propofol for total intravenous general anesthesia,and the control group received sufentanil combined with propofol forgeneral anesthesia.Observation was made on hemodynamic changes,anesthetic effect and adverse reactions inthe two groups.Results The observation group had stable hemodynamic indexes in perianesthesia period,whilethe control group had obviously fluctuated hemodynamic indexes.There was no statistically significant difference of hemodynamic indexes before drug administration(T0)between the two groups(P>0.05).The difference of hemodynamic indexes after anesthesia induction(T1),in5min after tracheal intubation(T2),intraoperative60min(T3)and at operation ending induction autonomous respiration(T4)had statistical significance between thetwo groups(P<0.05).The observation group had obviously shorter eye opening time,extubation time,onset timeand recovery time than the control group,and the observation group had much longer analgesic administration timethan the control group.Their differences all had statistical significance(P<0.05).The observation group had higherincidence of adverse reactions as20.0%than6.7%in the control group,while their difference had no statistical significance(P>0.05).Conclusion Implement of total intravenous general anesthesia by sufentanil combined with propofol for patients in hypertensive cerebral hemorrhage operation can stabilize hemodynamics of patients with excellent effect.This method is worth promoting.