目标bis监测下舒芬太尼与芬太尼对老年高血压患者全麻诱导气管插管应激反应的临床观察

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1、目标BIS监测下舒芬太尼与芬太尼对老年高血压患者全麻诱导气管插管应激反应的临床观察詹剑(泸州医学院附属医院麻醉科四川泸州646000)【摘要】目的：研究目标BIS监测下等效剂量舒芬太尼与芬太尼全麻诱导对老年高血压患者气管插管时心血管应激反应的影响。方法：60例全麻下行开腹手术的老年高血压患者，随机等分为F组和S组。F组：芬太尼3μg/kg；S组：舒芬太尼0.3μg/kgo两组患者均采用咪卩坐安定、异丙酚、顺式阿曲库钱麻醉诱导，BIS值为(45±5)时行气管插管。观察并记录麻醉前(T0)、气管插管前(T1)、插管后即刻(T2)、插管后5min(T3)、插管后

2、lOmin(T4)时MAP、HR、BIS值及血糖水平。结果：两组患者麻醉前(TO)及插管前(T1)BIS值及血糖水平无明显差异(P>0.05),但麻醉诱导后MAP、HR均较TO时明显下降(P<0.05),两组间并无统计学差异。气管插管后S组MAP、HR波动明显小于F组(P<0.05),BIS、血糖水平较插管前升高，但均低于F组。结论：BIS监测下等效剂量舒芬太尼、芬太尼对老年高血压患者全麻诱导气管插管时的应激反应均有明显抑制作用，但舒芬太尼诱导的抑制效果比芬太尼诱导的抑制效果更好。【关键词】舒芬太尼；芬太尼；应激反应；高血压；脑电双频指数【屮图分类号】R453【文献标识码】A【文章

3、编号】2095-1752(2016)04-0027-02ClinicalobservationofsufentanilandfentanyltargetunderBISmonitoringongeneralanesthesiainelderlypatientswithhypertensioninducedbytrachealintubationstressresponseZhanJian.AffiliatedHospitalofLuzhouMedicalCollege,SichuanProvince,Luzhou646000,China.【Abstract]ObjectiveTod

4、iscusstheclinicaleffectsofsufentanilandfentanylatequivalentdoseonstressreactionoftrachealintubationduringinductionofgeneralanesthesiainelderlyhypertensivepatientsundertargetBISmonitoring.MethodsSixtyelderlyhypertensivepatientsforelectiveabdominalsurgerywererandomlydividedintotwogroupsequally.g

5、roupF:3μg/kgfentanyl;groupN:0・3μg/kgsufentanil.Themidazolam,propofol,cisatracuriumwereusedtogeneralanesthesiainductionintwogroupsandtrachealintubationwassubsequentlyperformedwhentheBISwasintherangeof40-50.Themeanbloodpressure(MAP,)heartrate(HR),Bispectralindex(BIS)andbloodglucoselevelwer

6、eobservedandrecordedatpre-anesthesia(TO),beforeintubation(Tl),inaninstantafterintubation(T2)z5minutesafterintubation(T3),10minutesafterintubation(T4).ResultsTherewerenodifferencesonBISandbloodglucoselevelatTOandTl(P>0.05),butMAPandHRoftwogroupsatT1weresignificantlydecreasedthanT0(P>0.05)andnod

7、ifferencesbetweentwogroups.TheHRandMAPchangesofSgroupweremuchlessthanFgroupafterintubation(P>0.05)andBISandbloodglucoselevelofSgroupafterintubationwerehigherthanbeforeintubationbutbothlowerthanFgroup.ConclusionSufentanilandfentanylatequ