依托咪酯乳剂复合舒芬太尼用于全麻喉罩置入的临床观察

【】　目的　观察依托咪酯乳剂复合舒芬太尼用于全麻下喉罩置入的血流动力学变化。　方法　选择2009年4月-2010年2月间，46例需全麻手术、适合使用喉罩，美国麻醉医师协会（ASA）Ⅰ～Ⅱ级，年龄18～60岁的患者，随机分为两组依托咪酯乳剂组（E组）23例，静脉推注咪达唑仑0.05mg/kg，依托咪酯乳剂0.3mg/kg；依托咪酯乳剂+舒芬太尼组（ES组）23例，静脉推注咪达唑仑0.05mg/kg，依托咪酯乳剂0.15mg/kg，加舒芬太尼0.5mg/kg，诱导后置入喉罩，记录患者诱导前、用药后1min、喉罩置入后1min的心率（HR）、平均动脉压（MAP）以及评估喉罩置入条件的6项指标（张口困难分级、置入喉罩困难分级、舌咽反射、干咳干呕反射、肢动反应及喉痉挛分级），同时记录呼吸暂停时间。　结果　ES组能提供更好的喉罩置入条件，且能减少舌咽反射和肢体反应，更能保证喉罩置入时血流动力学的稳定。　结论　依托咪酯乳剂复合舒芬太尼能为全麻喉罩置入时提供更好的条件，且能保证更好的血流动力学稳定。？【Abstract】　Objective　Toinvestigatethehemodynamicschangeswhenetomidatecombinedwithsufentanilwasappliedforlaryngealmaskairwayinsertionunderthegeneralanaesthesia.　Methods　FromApril2009toFebruary2010,46patientsrequiringgeneralanesthesiausinglaryngealmaskairway(LMA)(AmericanSocietyofAnesthesiologists(ASA)Ⅰ-Ⅱ)aged18-60wererandomlydividedintotwogroups23inetomidateemulsiongroup(groupE)underwenttheintravenousinjectionwithmidazolm(0.3mg/kg)andetomidate(0.05mg/kg);23inetomidateemulsion+sufentanilgroup(groupES)underwenttheintravenousinjectionwithetomidate(0.15mg/kg),midazolm(0.05mg/kg),andsufentanil0.5mg/kg.ThepatientswereevaluatedbysixindexesofLMAinsertion(mouthopening,swallowingreflex,coughreflex,vomitingreflex,bodymotion,andlaryngospasmclassification).Aftertheanesthesiainduction,LMAwasinserted.Thebloodpressure(BP),heartrate(HR),andmeanarterialpressure(MAP)wererecordedbeforeanesthesiainductiononeminuteaftertheinjectionandoneminuteafterLMAinsertion.Meanwhile,theapneatimewasrecorded.　Results　ComparedwithgroupE,groupESofferedbetteranesthesiaforLMAinsertion,lessswallowingreflexandbodymotion,andmorestablehaemodynamics.　Conclusion　EtomidatecombinedwithsufentanilprovidesgoodconditionforLMAinsertionunderthegeneralanaesthesiawithsteadyhaemodynamics.