| 武丽芳 郝伟 于建设 解雅英 韩志强.比较不同浓度舒芬太尼靶控输注在清醒气管插管中的应用[J].,2015,15(25):4949-4952 |
| 比较不同浓度舒芬太尼靶控输注在清醒气管插管中的应用 |
| Application of Different Concentration Sufentanyl Target Control InfusionDuring Awake Tracheal Intubation |
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| DOI： |
| 中文关键词: 舒芬太尼 靶控输注 清醒气管插管 应激反应 血流动力学 |
| 英文关键词: Sulfentanyl Target-controlled infusion Awake tracheal intubation Stress -response Hemodynamics |
| 基金项目:内蒙古自治区自然科学基金项目（2010ms1142） |
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| 中文摘要: |
| 目的：比较清醒气管插管中不同浓度舒芬太尼靶控输注对血流动力学及应激反应的影响，探讨舒芬太尼应用于清醒气管插
管中的最适靶控浓度。方法：择期困难气道患者80 例，随机分为四组，每组20 例：A 组为对照组，静注生理盐水，B、C、D 组分别
接受舒芬太尼0.1 ng/mL、0.3 ng/mL、0.5 ng/mL效应室靶控输注，记录入室后（T0），达到设定血药浓度时(T1)、气管插管时（T2）和
气管插管后（T3）的收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2），分别于入室后、插管后3 min、5 min 采血测皮质
醇浓度。结果：①SBP：T1 时，B、C、D组均有不同程度的降低（P＜0.05），T3 时A、B 组明显升高（P＜0.05）；②DBP：T2 时A、B 组升
高显著（P＜0.05），C、D 组无较大变化（P＞0.05）；③HR：T1 时B、C、D 均下降，D 组下降最明显，与A、B、C 三组比较差异有统计
学意义（P＜0.05）；T2 时A、B 组HR 升高（P＜0.05），C、D 组插管前后变化不明显（P＞0.05）；④SpO2：组间、组内比较差异有统计
学意义（P<0.05）；⑤皮质醇：插管后三分钟C、D 组较A 组降低（P＜0.05），C、D 组内五分钟、三分钟同入室后比较皮质醇降低
（P＜0.05）。结论：0.3 ng/mL效应室浓度（ce）的舒芬太尼靶控输注可以有效的减弱清醒气管插管所致的应激反应，0.3ng/ml 以上效
应室浓度的舒芬太尼能将心血管反应抑制得更加完全。 |
| 英文摘要: |
| Objective:To investigate the optimum dose of sufentanyl target control infusion during tracheal intubation in sober
condition by comparing the effect of different awake target concentrations of sufentani1 target control infusion on the hemodynamic
response and stress reaction.Methods:Eighty patients with airway difficulty were equally and randomly divided into four groups. Group
A (control group) were infused with normal saline, the other groups received sufentani1 target concentration (STC) of 0.1 ng/mL (group
B), 0.3 ng/mL (group C), 0.5ng/mL (group D), respectively. SBP, DBP, HR, SpO2 were recorded when entering operating room(T0),
reaching the stated Plasma Concentration (T1), intubation (T2)and after intubation (T3), then collected blood and tested the cortisol
concentration (COR) at the time of entering operating room, 3min and 5min after tracheal intubation, respectively.Results:①SBP: SBP
of group B,C,D was decreased differently at T1(P< 0.05), and the SBP of group A and B had significant difference from T3 to T1 (P< 0.
05); ②DBP: The DBP of group A and B raised at T3(P<0.05), while compared with the basal level, there was no significant difference in
group C andD (P>0.05); ③ HR: HR of group B, C, D was decreased at T1, especially in group D which was statistically significant
compared with group A, B and C (P<0.05); HR of group A and B was increased at T3(P<0.05), but it didn't change obviously before and
after T3 in group C andD (P>0.05); ④SpO2: there was significant differences among or in each groups; ⑤COR: COR of group C and D
had statistical differences (P<0.05)compared with group A after tracheal intubation at 3 min. Within group B, the COR was decreased
significantly at 3 min and 5 min after tracheal intubation T3 (P<0.05).Conclusion:The effect concentration of sulfentanyl within 0.3
ng/mL could effectively weaken the stress reaction. When the effect concertration of sulfentanyl is more than 0.3 ng/mL, the
cardiovascular response could be suppressed more completely. |
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