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1、不同剂量芬太尼与舒芬太尼对高血压患者无痛支气管镜麻醉效果张洪军，李明星【摘要】目的比较不同剂量芬太尼与舒芬太尼在高血压患者支气管镜检查屮对应激反应的抑制效应。方法133例行支气管镜检查的高血压患者，随机分为三组:芬太尼2mg/kg(F2组,n=44),芬太尼4卩g/kg(F4组,n=43),舒芬太尼0.4ug/kg(S组，n二46)。各组诱导时先分别给与芬太尼2ug/kg、芬太尼4ug/kg、舒芬太尼0.4ug/kg,随后缓慢推注丙泊酚lmg/kg；意识消失后给予司口J林lmg/kg,肌肉松弛后置入喉罩
2、，镜检开始；术屮丙泊酚25〜75ug/(kg.min)持续泵入维持麻醉。记录诱导前(T1)、诱导后插入喉罩前(T2)、置入喉罩时(T3)、支气管镜过声门时(T4)、过声门后2min(T5)、灌洗刷检、活检或支气管扩张时刻(T6)患者的SBP和HR。记录患者术中Sp02变化和T3、T4、T6时刻呛咳和体动。结果与T1比，三组患者SBP在T2时刻均明显下降(PV0.05),F2组T3、T4明显升高(P<0.05)；与F2组比较，F4和S组SBP在T3、T4明显低(戶<0.05)。F2组患者在时刻呛咳及休动发
3、生率明显高于卩4和5组(啟0.05)。结论芬太尼4ug/kg及舒芬太尼0.4g/kg均能很好的抑制高血压患者在支气管镜检查屮的心血管应激反应。【关键词】芬太尼；舒芬太尼；高血压；支气管镜检查；应激反应EffectsofdifferentdosesoffentanylandsufentanilonstressresponseinhypertensivepatientsduringbronchoscopyFirstauthor:ZHANGHong-jun1MedicalSchoolofSoochowUniv
4、ersity2DepartmentofAnesthesiology,ShanghaiPulmonaryHospital,TongjiUniversitySchoolofMedicine,Shanghai,200433,ChinaCorrespondingauthor:LIMing-xing**DepartmentofAnesthesiology,ShanghaiPulmonaryHospital,TongjiUniversitySchoolofmedicine,Shanghai,200433,China
5、[Abstract]ObjectiveTocomparetheinhibitivecffectsofdiffcrcntdosesoffentemylandsufentanilinhypertensivepatientsdurin百bronchoscopyonstressresponse.Methods133patientsundergoingbronchoscopywithhypertensionwererandomlyassignedtooneofthreegroups:Fentanyl2ug/kg(
6、groupF2,n二44),Fentanyl4ug/kg(groupF4,n二43),Sufcntan订0.4g/kg(groupS,n二46).Eachgroupwasfirstlyinjectedintravenouslywithfentanyl2ug/kg>fentanyl2ug/kg>sufentanil0.4g/kgrespectively.Followedbypropofollmg/kgbyI.Vslowly,Afterthelossofconsciousness,succinylcholi
7、nelmg/kgwasinfusedineachgroups.laryngealmaskwasnotinserteduntilmusclerelaxation.thenbegintheprocedure.Propofolwerecontinuouslyinfusedatarateof25〜75ugkg~lminTtomaintaineanesthesia.SBP>DBPandHRwererecordedbeforeinduction(Tl)>afterinductionandbeforelaryngea
8、lmaskinsertion(T2)laryngealmaskinsertion(T3)bronchoscopethroughglottis(T4)、2minafterbronchoscopethroughglottis(T5)、duringlavage、biopsyanddilationofbronchus(T6)•inthemcantime,Sp02、coughandbodymovementatT3>T4>T6werealsoobser
