快通道冠脉旁路移植手术中芬太尼与舒芬太尼的麻醉效果的比较  

The Comparison of Sufentanil and Fentanil in Fast-track Anesthesia for Off-pump Coronary Artery Bypass Graft

作　　者：郭克芳[1] 罗红[1] 金翔华[1] 姜桢[1] 

机构地区：[1]复旦大学附属中山医院麻醉科,上海200032

出　　处：《中国临床医学》2008年第3期419-420,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:比较在非体外冠脉旁路移植手术(OPCABG)中舒芬太尼和芬太尼的麻醉效果。方法:选择择期进行OPCABG的患者60例,随机分为芬太尼组(F组)和舒芬太尼组(S组),每组30例。麻醉管理和术后处理标准化。记录血流动力学参数以及术中血管活性药、麻醉性镇痛药和异丙酚的用量。记录拔管时间、ICU滞留时间和出院时间。患者拔管后进行疼痛视觉模拟评分(VAS评分)。结果:两组患者术前一般情况无明显差异。与F组相比,S组术中心率和血压波动较小(P<0.05);苯肾上腺素的用量在S组明显低于F组(P<0.05)。术后F组平均机械通气时间为4.9h而S组为3.8h(P<0.05);两组的VAS评分、ICU滞留时间和出院时间均无明显差异。结论:在OPCABG中,舒芬太尼麻醉可减少血流动力学的波动,缩短机械通气时间,为快通道心脏麻醉的实施提供条件。Objective：To compare the anethetlc effects of sufentanil and fentanil for OPCABG surgery.Methods：Sixty adult patients undergoing selelbive OPCABG surgery were randomized to either fentanyl-based group or sufentanil-based anesthetic group.Anesthetic management and postoperative treatment were standardized according to our clinical routines.In addition to hemodynamic measurements,tracheal extubation time,length of ICU stay and hospital stay,dosages of inotropic agents,narcotics and propofol were recorded.Postoperative pain was measured after extubation according to visual analogue scale（VAS）.Results：There were no differences between groups regarding demographic characteristics.Compared to fentanil group,patients in sufentanil group had more stable heart rate and blood pressure,and fewer requirement for inotropic support.median ventilator time in sufentanil group was significantly shorter than that in fentanil group（3.8h vs.4.9h,P〈0.05）.However,nostatistical difference in postoperative pain scores,length of ICU stay and hospital stay.were foundConclusion：Sufentanil technique correlated with more stable hemodynamics and shorter ventilator support time and could be recommended for fast tracking cardiac anesthesia.

关 键 词：舒芬太尼 心脏手术 快通道心脏麻醉 

分 类 号：R614.2[医药卫生—麻醉学]