Sareen J, Hudson R J, Rosenbloom M, Thomson I R
Department of Anesthesia, University of Manitoba, Winnipeg, Canada.
Can J Anaesth. 1997 Jan;44(1):19-25. doi: 10.1007/BF03014319.
To determine the effect of a five-fold variation in sufentanil dose on the haemodynamic and electroencephalo graphic (EEG) response to anaesthetic induction and tracheal intubation.
Thirty-four patients undergoing elective coronary artery bypass grafting (CABG) participated in this randomized double-blind study. Patients in Group L (n = 17) received 3 micrograms.kg-1 sufentanil and those in Group H (n = 17) 15 micrograms.kg-1. Premedication was 60 micrograms.kg-1 lorazepam po. Anaesthesia and neuromuscular blockade were induced by infusing sufentanil and 0.15 mg.kg-1 vecuronium i.v. over five minutes. Haemodynamic data and the electroencephalographic (EEG) spectral edge were acquired by computer and compared at Control, Induction and Intubation.
Sufentanil dose did not affect the haemodynamic or EEG response at end-induction. No bradyarrhythmias occurred, and the incidence of hypotension was 12% in both groups. However, during induction apparent electromyographic artifacts and a transiently greater increase in heart rate were observed in Group H. The serum sufentanil concentration at Induction was 6.1 +/- 1.8 ng.ml-1 in Group L and 25.4 +/- 8.8 ng.ml-1 in Group H, and did not correlate with haemodynamic changes. No patient recalled any intraoperative event.
Increasing sufentanil dose from 3 to 15 micrograms-1 does not influence the ultimate haemodynamic response to induction. Combined with lorazepam premedication, 3 micrograms-1 sufentanil produces near-maximal haemodynamic and EEG effects and is adequate for induction and tracheal intubation of patients undergoing CABG. Sufentanil 15 micrograms.kg-1 is no more efficacious, and causes transient cardiovascular stimulation.
确定舒芬太尼剂量五倍变化对麻醉诱导和气管插管时血流动力学及脑电图（EEG）反应的影响。
34例行择期冠状动脉旁路移植术（CABG）的患者参与了这项随机双盲研究。L组（n = 17）患者接受3微克·千克⁻¹舒芬太尼，H组（n = 17）患者接受15微克·千克⁻¹。术前用药为口服60微克·千克⁻¹劳拉西泮。通过在5分钟内静脉输注舒芬太尼和0.15毫克·千克⁻¹维库溴铵诱导麻醉和神经肌肉阻滞。通过计算机获取血流动力学数据和脑电图（EEG）频谱边缘，并在对照、诱导和插管时进行比较。
舒芬太尼剂量在诱导结束时不影响血流动力学或EEG反应。未发生缓慢性心律失常，两组低血压发生率均为12%。然而，在诱导期间，H组观察到明显的肌电图伪迹和心率短暂性更大幅度增加。诱导时L组血清舒芬太尼浓度为6.1±1.8纳克·毫升⁻¹，H组为25.4±8.8纳克·毫升⁻¹，且与血流动力学变化无关。无患者回忆起任何术中事件。
将舒芬太尼剂量从3微克·千克⁻¹增加到15微克·千克⁻¹不影响诱导时的最终血流动力学反应。与劳拉西泮术前用药联合使用时，3微克·千克⁻¹舒芬太尼产生接近最大的血流动力学和EEG效应，足以用于CABG患者的诱导和气管插管。15微克·千克⁻¹舒芬太尼并无更高疗效，且会引起短暂的心血管刺激。
