舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响临床医学.docVIP

舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响临床医学 1 1资料与方法 3 11一般资料 3 12麻醉方法 3 13观察指标 3 14统计学方法 4 文2：心理干预对全麻患者苏醒期气管拔管时合作程度的影响 5 1 对象与方法 5 2 结果 7 3 讨论 7 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 10 正文 舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响临床医学 文1：舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响临床医学 Abstract： ObjectiveTo investigate the efficacy of sufentanil and esmolol in the prevention of cardiovascular respoe to extubation after general anesthesia. MethodsA total of 120 ASA I or II patients undergoing selective operation under general anesthesia were randomly divided into two groups (n=60/group). Group A was administered with sufentanil ( μg/kg), and Group B with sufentanil ( μg/kg) and esmolol (1 mg/kg). The paramete of systolic pressure (SP), diastolic pressure (DP), heart rate (HR), and concentratio of plasm adrenaline (Ad) and noradrenaline (NA) were compared between the two groups before induction, 5 min after endotracheal intubation and 5 min after extubation. ResultsThere were no significant differences in age, body weight, ASA class and complication between the two groups (P). SP, DP, HR and the concentratio of Ad and NA were significantly lower in Group B than in Group A (P). SP, DP, HR and the concentratio of Ad and NA were significantly higher after intubation than before induction in Group A (P), which lasted until 5 min after extubation, but they were not statistically changed in Group B (P ). ConclusionThe combination of sufentanil and esmolol can better prevent cardiovascular respoe to extubation after general anesthesia. Key words： anesthesia; extubation; stress 全麻气管拔管期间常常引起血浆儿茶酚胺浓度增加、血压升高、心率增快，使合并高血压、冠心病等高危因素病人麻醉危险性明显增加。而气管拔管时又不能通过加深全麻的方法来减轻应激反应的程度。许多药物如吸入麻醉药、交感神经阻滞药、血管扩张药、局部麻醉药、麻醉性镇痛药以及上述药物的结合被推荐应用于减轻气管插管反应［1］。艾司洛尔是一种新型药物，在国外已开始应用于临床麻醉，但国内目前报道较少。舒芬太尼是强效的阿片类镇痛药， 具有起效快、镇痛作用强、维持血流动力学稳定和安全性大等特点。本研究采用舒芬太尼复合艾司洛尔，观察其预防气管拔管应激反应的效果，为临床手术的顺利实施及减少术中或术后并发症提供理论依据。 1资料与方法 11一般资料 选择我院2006年8月—2007年8月全麻择