论文部分内容阅读
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、1.2μg/kg。记录4组患儿入室诱导前(T_1)、诱导后(T_2)、插管即刻(T_3)、插管后2 min(T_4)、插管后5 min(T_5)、插管后10 min(T_6)的心率(HR)和收缩压(SBP)及入室时(t_1)、插管后(t__2)、劈胸骨后(t_3)、复温开始时(t_4)、停机后10 min(t_5)、术后24 h(t_6)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,T_1时刻差异无统计学意义(P>0.05),T_2~T_6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,T_1时刻差异无统计学意义(P>0.05),T_2~T_6时刻差异均有统计学意义(P<0.05);皮质醇水平在t_1~t_4时刻差异无统计学意义(P>0.05),t_5~t_6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1.0μg/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。
Objective: To investigate the effects of different doses of sufentanil on hemodynamics and postoperative stress response in cardiac surgery in children with congenital heart disease. Methods: Forty children with ventricular tachycardia were divided into A, B, C and D groups according to the random number table method, 10 cases in each. Patients in groups A, B, C and D received intravenous sufentanil 0.6, 0.8, 1.0 and 1.2 μg / kg iv respectively during anesthesia induction. The levels of T_1, T_2, T_3, T_4, T_5 and T_6 after intubation were recorded before and after induction (T_2) ), Heart rate (HR), systolic blood pressure (SBP) and time to tachycardia (t_1), intubation (t__2), postpump sternum (t_3), the beginning of rewarming (t_4) After 24 h (t_6), acetylcholine (ACH), cortisol, glucagon, interleukin (IL) -6, lactate levels at each time point. Results: There was no significant difference at T 1 between the two groups (P> 0.05) and the difference of T 2 ~ T 6 at all time points was significant (P <0.05). The ACH, There was no significant difference in T_1 time between the two groups (P> 0.05), while there was a significant difference at T_2 ~ T_6 (P <0.05). The levels of cortisol between t_1 ~ There was no significant difference at t_4 (P> 0.05), but there was a significant difference at t_5 ~ t_6 (P <0.05). CONCLUSIONS: In sunstroke pediatric cardiac surgery, the dose of sufentanil at 1.0 μg / kg is most appropriate and has less effect on hemodynamics and postoperative stress response in children.