Effect Of Sufentanil Preconditioning On Myocardial Injury In Patients With Hypertension Of The Brachial Plexus Block

Objective :To investigate the effects of sufentanil pretreatment on myocardial injury in hypertensive patients with brachial plexus block.Methods:60 cases of hypertension patients with selective brachial plexus block,40 males and 20 females,American Society of Anesthesiologists(ASA)grade II-III,aged 45-65 years old,weight 45-90 kg.The diagnosis is in accordance with the essential hypertension,the grade of hypertension was grade 1-2,and the blood pressure is controlled within the range of elective surgery.The above patients were divided into A,B and C three groups according to the random number table method,Before brachial plexus block,given the same volume of saline(A group),sufentanil 0.1ug/kg(B group),sufentanil 0.2ug/kg(C group),After the patient entered the room,the peripheral venous puncture was performed and infusion fluid.At the same time,the routine indexes of blood oxygen,ECG,heart rate and blood pressure were monitored.Then,the anesthesiologist underwent brachial plexus block anesthesia guided by ultrasound for patients.The use of drugs: 1% ropivacaine hydrochloride 20 ml diluted with normal saline to 40 ml,according to the individual differences of patients and surgical requirements,take 0.5ml/kg slow injection,and control the anesthesia sensation plane in the range of C5-T1.recording the heart rate(HR)and mean arterial pressure(MAP)in each group before administration(T0),3min(T1)after administration,5min(T2)and 30min(T3)after administration.Venous blood 4 ml was taken to measure the levels of serum cardiac troponin I(c Tn I)and creatine kinase isoenzyme(CK-MB)by chemiluminescence method at two time points before administration(T0)and 24 h afteradministration(T4).Results:1 Comparison of three groups of patients in general1.1 There were no significant differences in age,sex,body weight and ASA grading among the three groups(P>0.05).2 Comparison of MAP and HR between the three groupsat different time points2.1 There was no significant difference in HR and MAP between the three groups at each time point(P>0.05).3 Comparison of CK-MB and c Tn I between three groups at different time points3.1 Three groups of patients were compared within groups:(1)At T4 time,the serum levels of c Tn I and CK-MB in the three groups were significantly higher than that at T0(P<0.05).3.2 Comparison between three groups of patients:(1)At the time of T0,the concentration of c Tn I and CK-MB in the three groups was not statistically significant(P>0.05).(2)At the time of T4,the concentrations of c Tn I and CK-MB in group C were significantly lower than those in group A(P<0.05);At the time of T4,Compared with group B,the concentration of c Tn I and CK-MB in group C decreased,but the difference was not statistically significant(P>0.05);At the time of T4,the concentrations of c Tn I and CK-MB in group B were lower than those in group A,but the difference was not statistically significant(P>0.05).Conclusion:Sufentanil pretreatment can not only stabilize the hemodynamics of patients,but also reduce the serum levels of c Tn I and CK-MB.Among them,the pretreatment of0.2ug/kg sufentanil can better reduce the serum levels of c Tn I and CK-MB,there is a certain degree of myocardial protection.