CAJ | 학술논문

目的：探讨舒芬太尼联合硝酸甘油对减轻高血压患者全身麻醉苏醒期拔管时引起的心血管应激反应的效果。方法选择该院麻醉复苏室（PACU）2013年5~10月收治的全身麻醉术后气管插管且自主呼吸未恢复的高血压复苏患者40例，并随机分成观察组和对照组，各20例。观察组患者采用静脉注射小剂量舒芬太尼联合硝酸甘油滴鼻，对照组患者采用硝酸甘油滴鼻。观察两组患者从入PACU到拔管后15 min各时期心率（HR）、平均动脉压（MAP）的变化。结果观察组在拔管时，拔管后5、15 min 的HR、MAP 明显低于对照组，差异均有统计学意义（P＜0.05）。结论舒芬太尼联合硝酸甘油可有效抑制高血压患者全身麻醉苏醒期拔管时的应激反应，值得临床推广应用。
목적：탐토서분태니연합초산감유대감경고혈압환자전신마취소성기발관시인기적심혈관응격반응적효과。방법선택해원마취복소실（PACU）2013년5~10월수치적전신마취술후기관삽관차자주호흡미회복적고혈압복소환자40례，병수궤분성관찰조화대조조，각20례。관찰조환자채용정맥주사소제량서분태니연합초산감유적비，대조조환자채용초산감유적비。관찰량조환자종입PACU도발관후15 min각시기심솔（HR）、평균동맥압（MAP）적변화。결과관찰조재발관시，발관후5、15 min 적HR、MAP 명현저우대조조，차이균유통계학의의（P＜0.05）。결론서분태니연합초산감유가유효억제고혈압환자전신마취소성기발관시적응격반응，치득림상추엄응용。
Objective To investigate the effect of sufentanil combined with nitroglycerin on cardiovascular stress reac-tion caused by hypertensive patients after general anesthesia during extubation. Methods Forty patients with hypertension re-covery,who were with general anesthesia tracheal intubation without autonomous respiration in PACU in the hospital from May to October of 2013,were randomized into observation group and control group,20 cases in each group. The observation group used intravenous injection of small dose sufentanil combined with nitroglycerin nasal drops ,while the control group adopted nasal drop-ping nitroglycerin. The changes of heart rate(HR) and mean arterial pressure(MAP) of the two groups from entering PACU to 15 min after extubation were observed. Results The HR and MAP on performing extubation,5 min after extubation and 15 min after extubation in the observation group were obviously lower than those in the control group ,and the difference was statistically sig-nificant(P<0.05). Conclusion Sufentanil combined with nitroglycerin can effectively inhibit the stress response in hypertensive patients during recovery from general anesthesia extubation , and it is worthy of clinical application.