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目的:观察布托啡诺先于舒芬太尼给药是否能够减轻老年患者麻醉诱导期血流动力学的波动。方法:60例ASA Ⅱ～Ⅲ级准备在全身麻醉下行择期手术的老年患者，随机分为2组，每组30例，麻醉诱导前，B组使用布托啡诺0.4 mg处理，C组使用相同容量的生理盐水处理。对比两组在开始诱导到插管结束后共15 min内的血压(MAP)和心率变化，记录需要药物干预的心血管不良事件数和诱导期呛咳的案例。心率血压均以动脉穿刺后5 min平均值作为基础血压进行标准化处理。结果:经过布托啡诺的预处理：(1)B组患者诱导期血压下降幅度低于C组(n P<0.05)，诱导后期维持在较高的水平(n P<0.05)；(2)B组患者诱导期心率下降程度低于C组(n P<0.05)，诱导后期两组之间差别不明显，但是插管诱发的心率变异较C组明显(n P<0.05)；(3)B组诱导期严重低血压的发生率小于C组(3.3%和56.7%，n χ2＝20.23，n P<0.0001)；(4)诱导期，B组呛咳反应低于C组(6.7%和43.4%，n χ2＝12.27，n P＝0.0005)。n 结论:通过布托啡诺处理，能够减少老年患者诱导期低血压的发生率和严重程度，同时减轻了诱导期呛咳的发生率。“,”Objective:To examine whether Butorphanol administered before Sufentanil can reduce hemodynamic fluctuations during the induction period in elderly patients.Methods:Sixty elderly patients with the American Society of Anesthesiologists(ASA)Ⅱ-Ⅲ scheduled for elective surgery under general anesthesia were randomly divided into two groups, with 30 patients in each group.Before anesthesia induction, patients in Group B were pretreated with Butorphanol(0.4 mg)and those in Group C were pretreated with the same volume of normal saline.Changes in blood pressure(MAP)and heart rate in the 15 min from the induction to the end of intubation were compared between the two groups.The incidences of adverse cardiovascular events requiring drug intervention and of cough during the induction period were recorded.The heart rate and blood pressure were standardized based on the mean value at 5 minutes after arterial puncture.Results:After pretreatment with Butorphanol, blood pressure experienced a less reduction in Group B than in Group C(n P<0.05), and maintained at a higher level in the later period of induction(n P<0.05); the decrease in heart rate was lower in Group B than in Group C(n P<0.05), but the difference between the two groups was not significant in the later period of induction, while heart rate variability induced by intubation was higher in Group B than in Group C; the incidence of severe hypotension was lower in Group B than in Group C(3.3%n vs.56.7%, n χ2=20.23, n P<0.0001); during the induction period, the incidence of cough was lower in Group B than in Group C(6.7%n vs.43.4%, n χ2=12.27, n P=0.0005).n Conclusions:Butorphanol pretreatment can reduce the incidence and severity of hypotension and the incidence of cough during the induction period in elderly patients.