The Influence On Hemodynamic Of Children Who Are Treated By Sufentanil Combine With Etomidate To Undergo Asd And Vsd Surgery Under The Cpb With Trachea Cannula Dring Anesthesia Induction

Objective: To evaluate the influence on hemodynamic of children who aretreated by the different doses of sufentanil combine with etomidate to undergoatrial septal defect (ASD) and ventricular septal defect (VSD) surgery under theCardiopulmonary Bypass (CPB) with trachea cannula during anesthesiainduction.Methods:80children，1to5years old,weight8to20kg, ASAⅡorⅢ,who would be undergone ASD or VSD surgery under CPB. According to thedifferent doses of sufentanil, the patients were recruited into the study anddivided into four groups: groupⅠ(n=20) received0.6ug/kg, groupⅡ(n=20) received0.8ug/kg, group Ⅲ (n=20)1.0ug/kg, group Ⅳ (n=20) received1.2ug/kg. After basal anesthesia, SBP, DBP, MAP, HR, ECG, SpO2and BIS werecontinuously monitored. Anesthesia was induced with midazolam0.1mg·kg-1,the different doses of sufentanil, etomidate0.3mg·kg-1and rocuronium0.6mg·kg-1. After tracheal intubation the patients were mechanically ventilated. Thediversification of SBP、HR and BIS were recorded at each time point whichwere before induction of anesthesia(T0), after induction of anesthesia(T1),intubation(T2), after intubation2min(T3)，5min (T4) and10min (T5), theincidence rate of hypotension, hypertension, bradyarrhythmia and tachycardiawere recorded during induction.Results: There was no significant difference of age, sex，weight andheight，ASA grade，cardiac function and cases of ASD and VSD in the fourgroups (P>0.05); SBP and HR do not have statistical significance (P>0.05) at T0in the four groups, the group Ⅳ was lower than the other groups at T1(P<0.05),group Ⅰ and Ⅱ each were higher than group Ⅲ and Ⅳ at T2(P<0.05);Compared with T0,SBP in group Ⅱ, Ⅲ,and Ⅳ was lower atT1(P<0.05), SBP in groupⅠ、Ⅱ、Ⅲwas higher at T2(P<0.05), HR in all groupwas slower at T1(P<0.05), HR in group Ⅰand Ⅱwas higher(P<0.05), groupⅣ was lower(P<0.05),but group Ⅲ was no significant difference atT2(P>0.05).There were no statistical differences between four groups in BIS atthe same point (P>0.05) and BIS reduced at each time point (P<0.05). Theincidence rate of hypotension and bradyarrhythmia in group Ⅳ was higher than other groups at T1(P<0.05), and the incidence rate of hypertension andtachycardia in groupⅠand Ⅱ each were higher than group Ⅲ and Ⅳ at T3,T4and T5.(P<0.05)Conclusion: In four groups, the group of1.0uɡ/kg sufentanil combinedwith0.3mɡ/kg etomidate have least stress response in trachea cannula duringanesthesia induction.