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The purpose of the brain craniotomy for tumor resection anesthesia, comparison of sufentanil and fentanyl for hemodynamic and anesthesia and emergence of adverse reactions and body stress response. Methods ASA Ⅰ - Ⅱ level in the cerebral craniotomy intracranial tumor resection and 50 patients were randomly divided into the sufentanil group (S) and fentanyl group (F), 25 patients in each. Conventional induction, intravenous midazolam 0.04mg/kg, propofol 2mg/kg the S group sufentanil 0.4μg/kg, the F group fentanyl 4μg/kg, the pending loss of consciousness, intravenous vecuronium bromide 0.1mg/kg. 3 minutes tracheal intubation connected to the ventilator the oxygen flow 2L/min, regulation of breathing parameters end-tidal carbon dioxide partial pressure was maintained at 30 ~ 35mmHg. Intubation after inhalation sevoflurane 1 ~ 2MAC, continuous intravenous infusion of propofol 3 ~ 4mg/kg/h inhalation anesthesia. Start a micro-pump surgery, respectively, continuous infusion of sufentanil 0.2μg/kg/h (s group), fentanyl 2μg/kg/h (F group). Vecuronium intervals for 45 ~ 60min after the induction of anesthesia, additional 2mg. Surgery based on MAP and HR changes. Sufentanil or fentanyl before the end of surgery about 30min withdrawal, stop off dural inhaled sevoflurane, propofol continuous infusion of the end of the Note to sew leather. Record: two sets of burglary quiet 10min (T 0 ), after induction (T 1 ), after intubation 1min (T 2 ), head frame fixed (T 3 ), skin incision (T 4 ), cut the dura mater (T 5 ), close the dura mater ( T 6 ), immediately after breathing recovery (the T 7 ), immediately after extubation (T 8 ) at each time point MAP, HR, SpO 2 ; burglary quiet after 10min, 30min after incision after extubation immediately, mining the radial artery laboratory blood sugar, blood concentration of epinephrine; observe and record the spontaneous breathing recovery time after surgery extubation time, to extubation after and 2h after the degree of pain and the incidence of adverse reactions. 48 hours after the follow-up level of pain, the analgesic applications and nausea, vomiting incidence of adverse reactions. Results Group F HR after intubation 1min, craniotomy, related cranial breathing is restored instantly and immediately after extubation were greater than the baseline values ??(P <0.05), S group HR craniotomy, breathing immediately after recovery and extubation immediately after were greater than the baseline values ??(P <0.05); two groups of MAP after induction, craniotomy, craniotomy closure reduced compared to baseline values, F group skin incision immediately after extubation MAP compared to baseline values ??increased (P <0.05 ); S group showed no significant difference (P> 0.05); the intracranial surgery group F in MAP, HR values ??were higher than the S group (P <0.05); spontaneous breathing recovery time, pull out the remaining time points with baseline values S group of tube time is shorter than the F group (P <0.05). S group, postoperative shivering, restlessness incidence is lower than the F group (P <0.05), postoperative nausea and vomiting were no significant differences between the two groups. Immediately after extubation, postoperative 2h S group VAS pain scores were lower than the F group (P <0.05), and 48h after follow-up VAS pain scores between the two groups was not significantly different. The two groups in the baseline values, after incision 30min, extubation immediately after blood glucose was no significant difference in blood epinephrine concentration difference. Conclusion Compared with fentanyl, sufentanil for neurosurgical patients anesthesia process more stable hemodynamics, able to effectively inhibit cardiovascular responses during intubation, anesthesia recovery period more stable postoperative shivering, restlessness The incidence of postoperative nausea, no significant difference in the incidence of vomiting. No significant differences in perioperative blood glucose, blood adrenaline level.
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