舒芬太尼对高血压患者全麻诱导应激反应的影响

王建芹; 姜峰; 王家友

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

舒芬太尼对高血压患者全麻诱导应激反应的影响

王建芹 , 姜峰 , 王家友

文章导航 > 蚌埠医学院学报 > 2011, 36 > 9: (945-948)

引用本文:

Citation:

舒芬太尼对高血压患者全麻诱导应激反应的影响

皖北煤电集团总医院麻醉科, 安徽宿州 234000

作者简介: 王建芹(1962-),女,主治医师.

中图分类号: R544.1

Effects of different target concentrations of sufentanil on the stress response to general anestbesia of hypertension patients tracheal intubation

Department of Anesthesiology, General Hospital of Wanbei Mining Affair Bureau, Suzhou Anhui 234000, China
CLC number: R544.1

摘要: 目的: 观察不同浓度舒芬太尼对高血压患者全麻诱导期应激反应的影响。方法: 全麻高血压患者60例,术前控制血压在一定范围内1周,随机均分为S1、S2、S3 3组,舒芬太尼血浆靶浓度分别为0.2、0.4和0.6 ng/ml。比较麻醉诱导各时段的血流动力学、脑电双频谱指数(BIS)、血浆肾上腺素(E)及去甲肾上腺素(NE)浓度。结果: 3组平均动脉压(MAP)、心率(HR)与T₀比较,S2组和S3组在T₁时刻MAP、HR均下降(P < 0.05~P < 0.01);S1组在T₂、T₃、T₄时刻MAP、HR均明显升高(P <0.01),S3组在T₃、T₄时刻MAP、HR均明显降低(P < 0.01)。BIS与T₀比较,3组在各时间点BIS值均降低(P < 0.01),其中S2组在T₁、T₂、T₃、T₄时刻变化范围在45~55之间,S1组在T₁、T₂、T₃、T₄时刻变化范围高于55,显示麻醉过浅,而S3组在各时点均低于45,显示麻醉过深。S2组插管后各时点血浆E、NE浓度差异均无统计学意义,S3组T₂、T₃时血浆E浓度低于S1组(P < 0.05~P < 0.01)。结论: 舒芬太尼靶控输注血浆靶浓度为0.4 ng/ml,能明显减轻高血压患者全麻诱导应激反应。
- 高血压 /
- 舒芬太尼 /
- 应激反应 /
- 麻醉,全身
Abstract: Objective: To study the effect of different target concentrations of sufentanil on the stress response to the hypertension patients tracheal intubation during induction of general anesthesia. Methods: Sixty hypertension patients were randomly divided into three groups with 20 cases each. Each group received a sufentanil target concentration(STC) of 0.2 ng/ml(S1),0.4 ng/ml(S2) and 0.6 ng/ml(S3),respectively. Mean arterial pressure(MAP),heart rate(HR),and bispectral index(BIS) were recorded at the time points of record baseline(T₀),immediately before intubation(T₁),immediately after intubation(T₂),1 min after intubation(T₃),3 min after intubation(T₄). Results: Compared to T₀ point,Map and HR of S2 and S3 were decreased(P < 0.05-P < 0.01); MAP and HR of S2 were all significant increased at T₂,T₃,T₄ point(P < 0.01), and of S3 at T₃,T₄ were signicantly decreased. Compared with T₀ point,BIS value of three groups were all decresed(P < 0.01),in which were in 45-55 range at T₁,T₂,T₃,T₄ of S2. BIS value of S1 were higher than 55 and of S3 were lower than 45,indicating too shallow or deep anesthesia. Comparison of norepinephrine (NE) concentration:T₀ compared,S1,S2,S3 at each time point was no significant difference(P > 0.05). Comparison with epinephrine(E) concentration:compared with T₀,T₃ of S1 was higher(P < 0.05). T₃,T₄ of S3 were always lower than S1(P < 0.05-P < 0.01),the difference was statistically significant. Conclusions: The hemodynamic response to the hypertension patients during induction of general anesthesia is stable as the target concentration of 0.4 ng/ml.
- hypertension /
- sufentanil /
- stress response /
- anesthesiology,general

[1]	许芾 , 岳洋 , 陈彪 , 杨如宵 . 七氟醚联合瑞芬太尼麻醉对腹腔镜下子宫肌瘤切除术病人应激反应及血流动力学的影响. 蚌埠医学院学报, 2020, 45(8): 1008-1012. doi: 10.13898/j.cnki.issn.1000-2200.2020.08.005
[2]	汤安俊 , 吴文玉 . 丙泊酚减轻颈丛麻醉甲状腺手术中应激反应观察. 蚌埠医学院学报, 2010, 35(12): 1274-1276.
[3]	李凌云 . 舒芬太尼联合丙泊酚全麻诱导对气管插管时血流动力学的影响. 蚌埠医学院学报, 2009, 34(8): 697-698.
[4]	王涛涛 , 翟明 , 郭睿 , 王南海 . 盐酸纳美芬对心脏手术全麻诱导期舒芬太尼诱发呛咳的预防作用. 蚌埠医学院学报, 2017, 42(4): 454-457,461. doi: 10.13898/j.cnki.issn.1000-2200.2017.04.011
[5]	王利 , 李若云 , 李秀贞 . 术前心理干预对全麻患者麻醉前及麻醉苏醒期的影响. 蚌埠医学院学报, 2014, 38(5): 681-682.
[6]	李晓立 , 文公堂 , 李晓红 , 薛梅 , 王南海 . 芬太尼对先天性心脏病手术麻醉时心血管反应的影响. 蚌埠医学院学报, 2006, 31(4): 352-354.
[7]	邓雪峰 , 何川 . 舒芬太尼复合罗哌卡因硬膜外麻醉用于急诊剖宫产效果观察. 蚌埠医学院学报, 2015, 40(11): 1517-1519. doi: 10.13898/j.cnki.issn.1000-2200.2015.11.017
[8]	张应柏 . 颅脑疾病病人手术中舒芬太尼麻醉效果观察. 蚌埠医学院学报, 2017, 42(7): 881-884. doi: 10.13898/j.cnki.issn.1000-2200.2017.07.013
[9]	文公堂 , 张建国 , 周菊 , 刘刚 . 舒芬太尼与瑞芬太尼在小儿扁桃体、腺样体切除手术中麻醉的比较. 蚌埠医学院学报, 2010, 35(9): 896-898.
[10]	李勇 , 陆松虹 , 程亮 , 潘松 . 舒芬太尼与氟比洛芬酯复合曲马多对雷米芬太尼复合麻醉苏醒期的影响比较. 蚌埠医学院学报, 2012, 36(4): 428-430.
[11]	朱姝颖 . 舒芬太尼联合丙泊酚全凭静脉麻醉用于胸科手术的临床观察. 蚌埠医学院学报, 2015, 40(5): 619-621. doi: 10.13898/j.cnki.issn.1000-2200.2015.05.019
[12]	薛强 . 两种麻醉方式对老年病人术后认知功能及应激反应的影响. 蚌埠医学院学报, 2018, 43(8): 1026-1029. doi: 10.13898/j.cnki.issn.1000-2200.2018.08.014
[13]	杨清峰 , 张旭 , 江泳 , 周磊 , 张爽 . 小剂量丙泊酚联合舒芬太尼静脉麻醉在食管静脉曲张套扎术中的应用. 蚌埠医学院学报, 2013, 37(1): 48-50,53.
[14]	路强 , 丁路 , 韩正飞 . 布比卡因复合舒芬太尼腰-硬联合麻醉在老年下肢骨折手术中的应用. 蚌埠医学院学报, 2014, 39(7): 903-906.
[15]	郑立东 , 李家宽 , 彭晓东 . 三磷腺苷对全身麻醉苏醒拔管期心血管反应的影响. 蚌埠医学院学报, 2011, 36(1): 52-53,56.
[16]	梁启胜 , 杨茗竣 , 符炜 , 凌云志 . 脑电双频指数指导下丙泊酚、舒芬太尼联合靶控对冠状动脉旁路移植术麻醉诱导期血流动力学影响. 蚌埠医学院学报, 2012, 36(10): 1155-1158.
[17]	周海 , 张腾云 , 吴娴 , 王建华 . 不同药物配伍用于小儿头颈部手术麻醉的效果比较. 蚌埠医学院学报, 2014, 38(1): 63-65.
[18]	郭芳 . 瑞芬太尼和芬太尼用于老年患者开胸手术麻醉的比较. 蚌埠医学院学报, 2009, 34(4): 327-329.
[19]	陆松虹 , 王忠云 . 雷米芬太尼和芬太尼分别联合丙泊酚诱导麻醉对气管插管患者血流动力学的影响. 蚌埠医学院学报, 2007, 32(2): 166-167.
[20]	吴莉 . 洛赛克预防高血压脑出血后急性应激性溃疡疗效观察. 蚌埠医学院学报, 2006, 31(5): 547-547.

点击查看大图

计量

文章访问数: 3277
HTML全文浏览量: 226
PDF下载量: 20
被引次数: 0

舒芬太尼对高血压患者全麻诱导应激反应的影响

作者简介: 王建芹(1962-),女,主治医师.

皖北煤电集团总医院麻醉科, 安徽宿州 234000

收稿日期: 2011-04-21

关键词:

摘要: 目的: 观察不同浓度舒芬太尼对高血压患者全麻诱导期应激反应的影响。方法: 全麻高血压患者60例,术前控制血压在一定范围内1周,随机均分为S1、S2、S3 3组,舒芬太尼血浆靶浓度分别为0.2、0.4和0.6 ng/ml。比较麻醉诱导各时段的血流动力学、脑电双频谱指数(BIS)、血浆肾上腺素(E)及去甲肾上腺素(NE)浓度。结果: 3组平均动脉压(MAP)、心率(HR)与T₀比较,S2组和S3组在T₁时刻MAP、HR均下降(P < 0.05~P < 0.01);S1组在T₂、T₃、T₄时刻MAP、HR均明显升高(P <0.01),S3组在T₃、T₄时刻MAP、HR均明显降低(P < 0.01)。BIS与T₀比较,3组在各时间点BIS值均降低(P < 0.01),其中S2组在T₁、T₂、T₃、T₄时刻变化范围在45~55之间,S1组在T₁、T₂、T₃、T₄时刻变化范围高于55,显示麻醉过浅,而S3组在各时点均低于45,显示麻醉过深。S2组插管后各时点血浆E、NE浓度差异均无统计学意义,S3组T₂、T₃时血浆E浓度低于S1组(P < 0.05~P < 0.01)。结论: 舒芬太尼靶控输注血浆靶浓度为0.4 ng/ml,能明显减轻高血压患者全麻诱导应激反应。

English Abstract

Effects of different target concentrations of sufentanil on the stress response to general anestbesia of hypertension patients tracheal intubation

Department of Anesthesiology, General Hospital of Wanbei Mining Affair Bureau, Suzhou Anhui 234000, China

Received Date: 2011-04-21

Abstract: Objective: To study the effect of different target concentrations of sufentanil on the stress response to the hypertension patients tracheal intubation during induction of general anesthesia. Methods: Sixty hypertension patients were randomly divided into three groups with 20 cases each. Each group received a sufentanil target concentration(STC) of 0.2 ng/ml(S1),0.4 ng/ml(S2) and 0.6 ng/ml(S3),respectively. Mean arterial pressure(MAP),heart rate(HR),and bispectral index(BIS) were recorded at the time points of record baseline(T₀),immediately before intubation(T₁),immediately after intubation(T₂),1 min after intubation(T₃),3 min after intubation(T₄). Results: Compared to T₀ point,Map and HR of S2 and S3 were decreased(P < 0.05-P < 0.01); MAP and HR of S2 were all significant increased at T₂,T₃,T₄ point(P < 0.01), and of S3 at T₃,T₄ were signicantly decreased. Compared with T₀ point,BIS value of three groups were all decresed(P < 0.01),in which were in 45-55 range at T₁,T₂,T₃,T₄ of S2. BIS value of S1 were higher than 55 and of S3 were lower than 45,indicating too shallow or deep anesthesia. Comparison of norepinephrine (NE) concentration:T₀ compared,S1,S2,S3 at each time point was no significant difference(P > 0.05). Comparison with epinephrine(E) concentration:compared with T₀,T₃ of S1 was higher(P < 0.05). T₃,T₄ of S3 were always lower than S1(P < 0.05-P < 0.01),the difference was statistically significant. Conclusions: The hemodynamic response to the hypertension patients during induction of general anesthesia is stable as the target concentration of 0.4 ng/ml.