不同剂量舒芬太尼对小儿心脏手术麻醉应激反应和血流动力学影响对比

Effect Comparison of Different Doses of Sufentanil on Anesthesia Stress Response and Hemodynamics in Pediatric Cardiac Surgery

目的探讨对比不同剂量舒芬太尼对小儿心脏手术麻醉应激反应和血流动力学影响。方法选取常州市儿童医院在2018年1月-2022年12月收治的68例小儿心脏手术患儿,对其临床资料进行回顾性分析,以不同剂量方案进行分组,对照组34例采取低剂量(2μg/kg)麻醉,试验组34例以高剂量(10μg/kg)麻醉,对两组不同时间节点的麻醉应激反应和血流动力学变化进行比较。结果试验组诱导前(T0)、诱导后(T1)、气管插管后(T2)、切皮劈胸骨后(T3)和阻断开放后(T4)时的去甲肾上腺素及肾上腺素水平均低于对照组,差异显著存在统计学意义(P<0.05);试验组诱导前(T0)、诱导后(T1)、气管插管后(T2)、切皮劈胸骨后(T3)和阻断开放后(T4)时的血流动力学指标(血压及心率)均明显高于对照组,比较差异存在统计学意义(P<0.05)。结论以高剂量(10μg/kg)麻醉小儿心脏手术麻醉中,麻醉效果较好,能够在不影响患者血流动力学的情况下,更好的降低患儿应激反应,保证手术顺利进行,值得临床推广。

Objective To explore and compare effect of different doses of sufentanil on anesthesia stress response and hemodynamics in pediatric cardiac surgery.Methods The paper reviewed and analyzed clinical data of 68 pediatric cardiac surgery patients admitted to Changzhou Children's Hospital from January 2018 to December 2022,and divided them into two groups with different dosage schemes.34 cases in control group were treated with low-dose anesthesia(2μg/kg),34 cases in experimental group with high-dose anesthesia(10μg/kg).Anesthesia stress response and hemodynamic changes at different time points were compared between two groups.Results Levels of norepinephrine and epinephrine in experimental group before induction(T0),after induction(T1),after tracheal intubation(T2),after skin incision and sternotomy(T3)and after blocking and opening(T4)were lower than control group,difference was statistically significant(P<0.05).Hemodynamic indexes(blood pressure and heart rate)before induction(T0),after induction(T1),after Tracheal intubation(T2),after skin incision and sternotomy(T3)and after blocking and opening(T4)in experimental group were significantly higher than control group,with statistical significance(P<0.05).Conclusion High dose anesthesia(10μg/kg)can achieve good anesthetic effect in pediatric cardiac surgery,can reduce stress response of patients and ensure smooth progress of the surgery without affecting hemodynamics of patients,which is worthy of clinical promotion.