舒芬太尼诱导麻醉老年特重烧伤削切痂手术的临床观察  

Sufentanil induced anethesia in the elderly with severe burn for surgical excision cutting

作　　者：张文龙[1] 卢承志[1] 刘建东[1] 蔡少甫[2] 郑庆亦[2] 

机构地区：[1]解放军175医院麻醉科,福建漳州363000 [2]解放军175医院烧伤科,福建漳州363000

出　　处：《东南国防医药》2011年第6期497-499,共3页Military Medical Journal of Southeast China

基　　金：福建省漳州市科技计划项目(Z06077)

摘　　要：目的探讨老年人特重烧伤削切痂麻醉时使用舒芬太尼诱导瑞芬太尼维持辅助镇痛效果。方法老年人特重度烧伤手术患者75例,随机分为舒芬太尼诱导瑞芬太尼维持组(SR组),芬太尼诱导瑞芬太尼维持组(FR组),单纯瑞芬太尼组(RR组),每组25例。观察诱导前(T0)、诱导插管时(T1)、插管后1 min(T2)、插管后5 min(T3)、切痂1 min(T4),取皮1 min(T5)、平均动脉压(MAP)、心率(HR)值、记录术中体动、知晓情况、麻醉苏醒质量及术后4 h视觉模拟量表评分(VAS),静脉患者自控镇痛(PCIA)药物用量及术后并发症发生情况。结果麻醉期间血流动力学稳定SR组优于FR、RR组(P<0.01或P<0.05),术后4 h VAS评分及PCIA药物用量,SR组低于FR、RR组,FR组低于RR组(P<0.01);术后躁动SR组低于FR、RR组(P<0.01),FR组与RR组无差异;SR、RR组两组睁眼时间和拔管时间明显短于FR组(P<0.01),SR组与RR组无差异。结论接受舒芬太尼诱导麻醉的老年特重度烧伤患者,其术中血流动力学比较稳定,苏醒快速,不良反应少。Objective To explore the efficacy of sufentanil induced anesthesia in severe burn patients cutting of old crust to maintain auxiliary of remifentanil analgesia.Methods 75 elderly patients with severe burn surgery were randomly divided into remifentanil sufentanil induction of the maintenance group（SR group）,fentanyl,remifentanil induced by the maintenance group（FR group）,remifentanil Group（RR group）.Each group includes 25 patients.Observation was done before induction（T_0）,during induction and intubation（T_1）,after intubation 1 min（T_2）,after intubation 5 min（T_3）,escharectomy 1 min（T_4）,take the skin 1 min（T_5）.The mean arterial pressure（MAP）,heart rate（HR） values were recorded at the body movement and aware of the situation.The quality of anesthesia,after 4 hours visual analog scale score（VAS）,patient-controlled intravenous analgesia（PCIA） drug use and the occurrence of postoperative complications were recorded as well.Results Hemodynamic stability during anesthesia in SR group better than that in FR and RR group（P0.01 and P0.05）.The VAS score after 4 hours and PCIA drug dosage in SR group were lower than that in FR and RR group（P0.01）.The postoperative agitation in SR group occurred fewer than that in FR,RR group（P0.01）.No differences were found in FR and RR.The opening eyes and extubation time in SR and RR group were significantly shorter than that in FR group（P0.01）,no differences in SR and RR were found.Conclusion Sufentanil induced anethesia in the elderly with severe burn for surgical excision cutting can maintain supplemental analgesia in intraoperative,keep hemodynamic stability,recovery fast and adverse reactionsreactions.

关 键 词：特重烧伤 老年人 全身麻醉 

分 类 号：R826.54[医药卫生—临床医学]