舒芬太尼联合硝酸甘油对高血压患者全身麻醉苏醒期拔管时应激反应的影响

摘要

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。%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.