摘要
目的观察舒芬太尼与芬太尼麻醉对老年腹腔镜胆囊切除术患者血流动力学的影响。方法选取2016年4月~2017年8月在我院择期行腹腔镜胆囊切除术的156例ASAⅠ~Ⅱ级老年患者作为研究对象,应用随机数字表法将其随机分为芬太尼组和舒芬太尼组,每组78例。芬太尼组联合应用芬太尼进行麻醉诱导和维持,舒芬太尼组应用舒芬太尼。比较两组患者麻醉诱导前(T_0)、诱导后(T_1)、插管时(T_2)、拔管后(T_3)的心率(HR)、收缩压(SBP)、舒张压(DBP)变化,同时,比较两组患者麻醉后的苏醒情况及不良反应发生情况。结果两组患者T1时的HR、SBP、DBP均明显低于T_0,T_2、T_3时明显高于T0(P<0.05)。舒芬太尼组T1时的HR、SBP、DBP明显高于芬太尼组,T_2、T_3时的HR、SBP、DBP明显低于芬太尼组(P<0.05)。舒芬太尼组患者的麻醉苏醒、自主呼吸恢复及拔管所需时间均明显短于芬太尼组(P<0.01)。舒芬太尼组的呼吸抑制、胃肠道反应、烦躁不安、心律失常等不良反应总发生率明显低于芬太尼组(P<0.05)。结论在老年腹腔镜胆囊切除术患者的麻醉诱导和维持中,芬太尼和舒芬太尼都可影响患者的血流动力学,但舒芬太尼相比芬太尼在维持其血流动力学稳定中的作用更显著,同时其还能促进患者麻醉后苏醒,不良反应少,值得临床推广应用。
Objective To observe the influence of Sufentanil and Fentanyl used for anaesthesia on hemodynamics in elderly patients with laparoscopic cholecystectomy.Methods 156 elderly patients with grade Ⅰ - Ⅱof ASA and scheduled for laparoscopic cholecystectomy in our hospital from April 2016 to August 2017 were selected as object and they were randomly divided into the Sufentanil group and Fentanyl group according to the random number table method,and there were 78 eases in each group.The Fentanyl group was combined with Fentanyl for anesthesia induction and maintenance, and Sufentanil was used in the Sufentanil group.The change of HR,SBP and DBP before anesthesia induction （T0）,after induction （T1）,intubation （T2） and after extubation （T3） in patients between the two groups were compared.At the same time,the revival situation and the incidence of adverse reactions in patients between the two groups were compared. Results HR, SBP and DBP at T1 were significantly lower than those at To in the two groups,and the abovementioned-indexes at T2 and T3 were significantly higher than those at To （P〈0.05）.HR,SBP and DBP at T1 in the Sufentanil were significantly higher than those in the Fentanyl group,and HR,SBP and DBP at T2,T3 in the Sufentanil were significantly lower than those in the Fentanyl group （P〈0.05）.Time required for anaesthesia recovery, spontaneous breathing recovery and extubation in patients of the Sufentanil group were significantly shorter than those of the Fentanyl group （P〈0.01）. The total incidence of respiratory depression,gastrointestinal reaction,irritability and arrhythmia and so on in the Sufentanil group was significantly lower than that of the Fentanyl group （P〈0.05）.Conclusion In the induction and maintenance of anesthesia for elderly patients with laparoscopic cholecystectomy,Fentanyl and Sufentanil can influence the hemodynamics of patients,but compared with Fentanyl,Sufentanil in maintaining the hemodynamic stability has a more prominent role,at the same time,it can also promote the recovery of patients after anesthesia with fewer adverse reactions,it is worthy of clinical promotion and application.
出处
《中国当代医药》
2018年第3期67-69,72,共4页
China Modern Medicine
