CAJ | 학술논문

目的：探讨小儿麻醉中无肌肉松弛药情况下两种剂量舒芬太尼联合丙泊酚及七氟烷诱导在气管插管条件和抑制气管插管心血管反应方面的效果。方法选取2011年7月至2012年4月南宁市妇幼保健收治的90例择期小儿腹腔镜手术患者，用随机数字表法分为C组、S3组和S4组，每组30例，分别给予罗库溴铵0.6 mg／kg、舒芬太尼0.3μg／kg、舒芬太尼0.4μg／kg联合丙泊酚和七氟烷行麻醉诱导。记录诱导前基础值（T0）、气管插管前（T1）、插管中（T2）、插管后1 min（T3）、3 min （ T4）、5 min（ T5）的心率、收缩压与基础值的差值；记录各组气管插管条件评分及临床可接受评分例数。结果各时点间心率与基础值差值，C组中T2高于T1（P＜0.05）；各时点间收缩压与基础值差值，C组中T2高于T1（P＜0.05）；C组气管插管条件评分优于S3组（P＜0.05）；C组与S4组比较，差异无统计学意义（ P＞0.05）。结论小儿全麻中，舒芬太尼联合丙泊酚及七氟烷无肌肉松弛药诱导，可有效抑制气管插管心血管反应，提供较满意的气管插管条件。舒芬太尼0.4μg／kg诱导作用与罗库溴铵相似。
목적：탐토소인마취중무기육송이약정황하량충제량서분태니연합병박분급칠불완유도재기관삽관조건화억제기관삽관심혈관반응방면적효과。방법선취2011년7월지2012년4월남저시부유보건수치적90례택기소인복강경수술환자，용수궤수자표법분위C조、S3조화S4조，매조30례，분별급여라고추안0.6 mg／kg、서분태니0.3μg／kg、서분태니0.4μg／kg연합병박분화칠불완행마취유도。기록유도전기출치（T0）、기관삽관전（T1）、삽관중（T2）、삽관후1 min（T3）、3 min （ T4）、5 min（ T5）적심솔、수축압여기출치적차치；기록각조기관삽관조건평분급림상가접수평분례수。결과각시점간심솔여기출치차치，C조중T2고우T1（P＜0.05）；각시점간수축압여기출치차치，C조중T2고우T1（P＜0.05）；C조기관삽관조건평분우우S3조（P＜0.05）；C조여S4조비교，차이무통계학의의（ P＞0.05）。결론소인전마중，서분태니연합병박분급칠불완무기육송이약유도，가유효억제기관삽관심혈관반응，제공교만의적기관삽관조건。서분태니0.4μg／kg유도작용여라고추안상사。
Objective To investigate the therapeutic effect of two dosages of sufentanil combined with propofol and sevoflurane for induction without neuromuscular block from the aspect of intubating conditions and attenuating cardiovascular responses to intubation in children .Methods A total of 90 children undergo-ing elective laparoscopic surgery under general anesthesia from Nanning Women and Children Hospital during Jul.2011 and Apr.2012 were included.All children were randomly divided into three groups(group C,S3, and S4,30 cases in each group).Anesthesia was induced with propofol, sevoflurane, and rocuronium 0.6 mg/kg (C),sufentanil 0.3 μg/kg(S3),0.4 μg/kg(S4) respectively.The difference value(D-value) between various time-points and baseline in heart rate and systolic blood pressure were recorded before induc-tion(baseline,T0), before intubation(T1),at intubation(T2),at 1 min(T3),3 min(T4),5 min(T5) after intubation.The intubating conditions score,the number of acceptable intubating conditions were recorded. Results The D-value in HR increased at T2 compared to T1 in group C(P<0.05).The D-value in SBP increased at T2 than at T1 in group C(P<0.05).Intubating conditions score in group C preceded those in group S3(P<0.05),and weren′t signi cantly different compared to group S4(P >0.05).Conclusion Sufentanil combined with propofol and sevoflurane for induction without neuromuscular block in children blunts effectively cardiovascular responses to intubation and provides adequate intubating conditions .Sufen-tanil 0.4 μg/kg as induction dose provides similar intubating conditions with rocuronium .