舒芬太尼复合瑞芬太尼在插管全麻手术患者中应用及对血液动力学和应激反应影响.docVIP

舒芬太尼复合瑞芬太尼在插管全麻手术患者中应用及对血液动力学和应激反应影响 　　[摘要]目的 探究舒芬太尼复合瑞芬太尼在插管全麻手术患者中的应用及对血液动力学和应激反应的影响。方法 选取2014年4月～2017年4月我院收治的62例插管全麻手术患者作为研究对象，采用计算机随机数字表法将其分为联合组和对照组，每组各31例。联合组患者予以舒芬太尼复合瑞芬太尼麻醉，对照组患者予以瑞芬太尼麻醉。观察两组患者在麻醉前（T0）、插管后（T1）、拔管后（T2）的血流动力学[心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2）]和应激指标[肾上腺素（E）、去甲肾上腺素（NE）]水平变化情况，比较两组患者的术后视觉模拟（VAS）评分。结果 与T0时刻比较，两组患者T1、T2时刻的HR、血清N、NE均升高，且联合组患者低于对照组，差异均有统计学意义（P0.05）。对照组患者T1、T2时刻的MAP均高于T0时刻，且联合组低于对照组，差异均有统计学意义（P0.05）。术后4 h，联合组患者的VAS评分低于对照组，差异有统计学意义（P0.05）。结论 舒芬太尼复合瑞芬太尼能有效维持插管全麻手术患者的血流动力学稳定，降低应激水平，并缓解术后疼痛。 　　[关键词]舒芬太尼；瑞芬太尼；血液动力学；应激反应 　　[中图分类号] R614.21 [文献标识码] A [文章编号] 1674-4721（2018）3（c）-0065-03 　　[Abstract]Objective To explore the application of Sufentanil combined with Remifentanil in patients undergoing general anesthesia for intubation and its influence on hemodynamics and stress response.Methods From April 2014 to April 2017，62 patients undergoing intubation in general anesthesia in our hospital were evenly divided into combination group and control group by computer randomization，31 cases in each group.Patients in the combination group were given Sufentanil and Remifentanil，and those in the control group，Remifentanil alone was provided.The hemodynamics including heart rate （HR），mean arterial pressure （MAP），and oxyhemoglobin saturation （SpO2） and stress indicators of epinephrine （E），norepinephrine （NE） before anesthesia （T0），after intubation （T1），tube drawing （T2） were observed between the two groups.The postoperative visual analogue scale （VAS） score between the two groups was also compared.Results Compared with T0，the levels of HR，E and NE at T1 and T2 were all increased，and the indicators in the combination group were lower in comparison with those in the control group，the differences were statistically significant （P0.05）.The MAP levels at T1 and T2 were elevated compared with that at T0，and those indexs of the combined group were lower than those of the control group，the differences were statistically significant （P0.05）.Four hours after surge