【摘要】 目的 通过舒芬太尼和芬太尼用于甲状腺相关眼病矫正术的麻醉诱导，观察其血流动力学变化特点及术后清醒、拔管情况，寻求安全、有效的麻醉方法。方法 60例甲状腺相关眼病患者，随机分成2组，舒芬太尼组(S组，n=30)，芬太尼组(F组，n=30)。麻醉诱导分别以S组：力月西0.05mg/kg、舒芬太尼1μg/kg、依托咪酯0.3mg/kg、阿曲库铵0.5mg/kg；F组：力月西0.05mg/kg、芬太尼3～4μg/kg、依托咪酯0.3mg/kg、阿曲库铵0.5mg/kg。记录麻醉前(基础值、T0)、麻醉诱导后(T1)、插管时(T2)、插管后1min(T3)、3min(T4)、5min(T5)时的收缩压(SP)、舒张压(DP)、心率(HR)、脉搏血氧饱和度(SpO2)及术后清醒、拔管时间。结果 S组麻醉诱导后及插管期间的SP、DP、HR较F组低(P<0.05或0.01)；S组在T1～T5各时点SP、DP、HR均较T0明显下降(P<0.05或0.01)，而F组在T2、T3、T4时点较T0有所升高(P<0.05)；苏醒及拔管时间S组较F组明显缩短(P<0.05)。结论 舒芬太尼用于甲状腺相关眼病矫正术的全麻诱导血流动力学更稳定，术后清醒、拔管时间更短。

    【关键词】 舒芬太尼，芬太尼；甲状腺相关眼病；眶脂肪脱出术；血液动力学；全身麻醉

    【Abstract】 Objective To explore the effects of sulfentanyl or fentanyl during general anesthesia in patients undergoing fat removal orbital decompression in thyroid-associated ophthalmopathy.Methods 60 patients with thyroid-associated ophthalmopathy scheduled undergoing fat removal orbital decompression were randomly divided into two groups. Group S was induced with midazolam 0.05mg/kg, sulfentanyl 1μg/kg, etomidate 0.3mg/kg, and atracurium 0.5mg/kg(n=30); group F was midazolam 0.05mg/kg, fentanyl 3～4μg/kg, etomidate 0.3mg/kg, and atracurium 0.5mg/kg(n=30). Systolic blood pressure(SP), diastolic blood pressure(DP),heart rate(HR) and SpO2 were recorded before anesthesia(T0), immediately after induction(T1), during tracheal intubation (T2), 1minutes(T3),3minutes(T4),5minutes(T5) after intubation.Time to awake and extubation were also recorded.Results SP,DP,HR after induction and during tracheal intubation were significantly lower in Group S than in Group F(P<0.05);SP,DP,HR at T1～T5 decreased significantely (P<0.05),and increased at T2、T3、T4 in Group F after induction(P<0.05).Time to awake and extubation were significantly shorter in Group S than in Group F(P<0.05).Conclusion Hemodynamic responses of sulfentanyl induction in patients undergoing fat removal orbital decompression in thyroid-associated ophthalmopathy were more stable,and time to awake and extubation were shorter. ......