【摘要】 目的对比分析舒芬太尼和咪唑安定对行脑动脉瘤栓塞术患者麻醉效果及血清白介素-6(Interleukin-6;IL-6)、肿瘤坏死因子α(Tumor necrosis factor-α;TNF-α)水平的影响.方法以2012年5月至2014年4月汉中市中心医院行脑动脉瘤栓塞术的58例患者作为研究对象,随机分为S组和M组,S组采用舒芬太尼维持麻醉,M组给予咪唑安定维持麻醉.比较2组患者麻醉前、麻醉诱导后5 min、股动脉置管后以及手术结束时平均动脉压(mean arterial pressure;MAP)、心率(heart rate;HR)情况;记录停药后患者自主呼吸恢复、意识恢复、导管拔除以及定向力恢复时间;检测麻醉前、手术前、术后1h、术后24 h及术后48 h 2组患者血清IL-6、TNF-α水平.结果麻醉前和诱导后2组患者MAP和HR比较差异无统计学意义(P>0.05),股动脉置管后以及手术结束时2组患者MAP和HR差异具有统计学意义(P<0.05).术后S组患者自主呼吸恢复时间、意识恢复时间、拔管时间以及定向力恢复时间均明显短于M组,差异具有统计学意义(P<0.05).手术前、手术后1 h、术后24 h及术后48 h 2组患者血清IL-6和TNF-α水平与麻醉诱导前相比均有明显升高(P<0.05),且相同时点S组患者血清TNF-α水平增高幅度均低于M组(P<0.05).结论舒芬太尼在行脑动脉瘤栓塞术中有较好的麻醉效果,且炎症反应较小,适合临床推广应用.更多还原

【Abstract】 Objective To analyze the anesthetic effect of Sufentanil and Midazolam on embolization of cerebral aneurysms and compare the influence of two drugs on levels of Interleukin- 6(IL- 6) and Tumor necrosis factor- α(TNF- α) during perioperative period.Methods 58 patients with cerebral aneurysm were randomly divided into two groups.Patients in group S received Sufentanil anesthesia, and patients in group M were given Midazolam anesthesia.The mean arterial pressure(MAP) and heart rate(HR) were recorded before anesthesia,5 minutes after anesthesia induction, after femoral artery catheter and after operation.Times to recovery of spontaneous breathing and consciousness and catheter removal and environmental interpretation were recorded.The levels of IL- 6 and TNF- α were measured before anesthesia, 1 h and 24 h and 48 h after operation.Results There were no significant differences in MAP and HR before anesthesia and after anesthesia induction(P>0.05).There were significant differences in MAP and HR between group S and group M after femoral artery catheter and after operation(P<0.05).Times to recovery of spontaneous breathing and consciousness and catheter removal and environmental interpretation of group S were significantly shorter than group M(P<0.05).The levels of IL- 6 and TNF- α were significantly increased before operation and 1 h,24 h,48 h after operation,according to the levels before anesthesia induction(P<0.05),and the levels of TNF- α in group S were lower than group M at the same point time(P <0.05).Conclusion Sufentanil in the operation of cerebral aneurysm embolization has a better anesthetic effect and less inflammatory response, and is suitable for clinical application.更多还原