不同剂量舒芬太尼对患儿心脏手术麻醉中血流动力学及术后应
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篇名: 不同剂量舒芬太尼对患儿心脏手术麻醉中血流动力学及术后应
TITLE:
摘要:

目的:探讨不同剂量舒芬太尼对先天性心脏病患儿心脏手术麻醉中血流动力学以及术后应激反应的影响。方法:40 例

行室缺修补的患儿按随机数字表法分为A、B、C、D组,各10 例。A、B、C、D组患儿麻醉诱导时分别静脉注射舒芬太尼浓度为0.6、

0.8、1.0、1.2 μg/kg。记录4 组患儿入室诱导前(T1)、诱导后(T2)、插管即刻(T3)、插管后2 min(T4)、插管后5 min(T5)、插管后10 min

(T6)的心率(HR)和收缩压(SBP)及入室时(t1)、插管后(t2)、劈胸骨后(t3)、复温开始时(t4)、停机后10 min(t5)、术后24 h(t6)各时刻

乙酰胆碱(ACH)、皮质醇、胰高血糖素、白介素(IL)-6、乳酸水平。结果:4 组患儿HR、SBP水平组间比较,T1时刻差异无统计学意

义(P>0.05),T2~T6各时刻差异均有统计学意义(P<0.05);4 组患儿ACH、胰高血糖素、IL-6、乳酸水平组间比较,T1时刻差异无统

计学意义(P>0.05),T2~T6时刻差异均有统计学意义(P<0.05);皮质醇水平在t1~t4时刻差异无统计学意义(P>0.05),t5~t6时刻

差异有统计学意义(P<0.05)。结论:小儿心脏手术麻醉中,选择舒芬太尼的剂量以1.0 μg/kg 最为适宜,对患儿血流动力学和术后

应激反应的影响较小。

ABSTRACT:

OBJECTIVE:To explore the effects of different doses of sufentanil on hemodynamics and postoperative stress response

of children with congenital heart disease in cardiac surgery anesthesia. METHODS:40 children underwent ventricular septal

defect repair in our hospital were divided into group A,B,C and D with 10 cases in each group according to the dose of sufentanil.

Groups A,B,C and D were given intravenous injection of sufentanil(0.6,0.8,1.0,1.2 μg/kg)respectively during anesthesia

induction. Heart rate(HR)and systolic blood pressure(SBP)of 4 groups were recorded before induction(T1),after induction

(T2),intubation(T3),2 min after intubation(T4),5 min after intubation(T5),and 10 min(T6)after intubation. The contents of

acetylcholine(ACH),cortisol,glucagon,IL-6 and lactic acid were recorded when getting into the operating room(t1),after intubation(

t2),after spliting the sternum(t3),before rewarming(t4),10 minutes after the shutdown the CPB(t5)and 24 h after operation(

t6). RESULTS:There was no significant differences in HR and SBP between 4 groups at T1(P>0.05); but there was statistically

significant difference between 4 groups at T2-T6(P<0.05). There was no statistical significant difference in ACH,glucagon,

IL-6 and lactic acid between 4 groups at T1(P>0.05);but there was statistically significant difference between 4 groups at T2-T6

(P<0.05). There was no statistically significant difference in cortisol between 4 groups at T1-T4(P>0.05);but there was statistically

significant difference between 4 groups at T5-T6(P<0.05). CONCLUSIONS:During pediatric cardiac surgery anesthesia,the

concentration of sufentanil kept in 1.0 μg/kg is the most suitable,and has small effect on hemodynamics and postoperative stress response.

期刊: 2015年第26卷第35期
作者: 位义芳
AUTHORS: WEI Yi-fang
关键字: 舒芬太尼;先天性心脏病;血流动力学;应激反应;麻醉剂量
KEYWORDS: Sufentanil;Congenital heart disease;Hemodynamics;Stress response;Anesthesia dose
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