关键词: 芬太尼, 血流动力学, 应激 , 瑞芬太尼, 舒芬太尼

Abstract: To compare the effects of sufentanil, remifentanil or fentanyl on hemodynamic and stress responses of patients during induction of general anesthesia. Methods： In a randomized, doubleblind study, sixty ASA Ⅰ～Ⅱ patients undergoing elective abdominal surgery under general anesthesia were divided into sufentanil group (S, n=20), remifentanil group (R, n=20) and fentanyl group (F, n=20). SBP, DBP, MAP, HR and SpO2 were recorded before induction of anesthesia (T, baseline), immediately after tracheal intubation (T0), 1, 3 and 5minutes after intubation(T1, T2, T3). At the same time, plasma norepinephrine(NE) and epinephrine(E) were determined by high performance liquid chromatography. Results： The MAP and HR in three groups at T0 were significantly lower than those at T, and decreased much greatly in group R than in group F and S. The MAP and HR in group F significantlyincreased at T1 than T, and returned to baseline at T2 and T3. The MAP and HR in group R at T1 were not significantly different from those at T, but gradually decreased; the levels at T2,　T3 were significantly lower than at baseline and in group F or S. Compared with the baseline, the MAP and HR in group S at T1,　T2,　T3　remained unchanged. In group R, there were two patients whose HR were under 55•min-1. In group F, the plasma NE and E at T1, T2 were significantly higher than those at T. In group R and S, there were no significant changes in plasma NE and E, which were all within normal range. Conclusion： Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia. At the same time, sufentanil has better hemodynamic stability.

Key words: Sufentanil, Remifentanil, Fentanyl, Hemodynamic, Stress