舒芬太尼复合丙泊酚与芬太尼两种麻醉方式的临床效果对照研究  

The control study on the clinical effect of the two anesthesia ways of Sufentanil combined with Propofol and Fentanyl

作　　者：李平萍[1] 李传文[1] 孙庆燕[1] 

机构地区：[1]山东省济宁医学院附属医院麻醉科,山东济宁272000

出　　处：《中国医药导报》2011年第35期90-91,101,共3页China Medical Herald

摘　　要：目的:对比观察舒芬太尼复合丙泊酚与芬太尼对苏醒及苏醒期间血流动力学的影响。方法:66例择期行非体外循环冠状动脉搭桥手术(OPCABG)患者,将其随机分为观察组(34例)和对照组(32例),观察组术中采用舒芬太尼与丙泊酚持续泵入维持麻醉;对照组术中采用芬太尼持续泵入维持麻醉。所有患者连续监测收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)等血流动力学指标,观察两组患者苏醒时间、拔管时间及警觉/镇静评分(OAA/S)。结果:插管时,观察组SBP、DBP、MAP、HR分别为(89.1±8.9)、(74.9±3.6)、(76.7±7.5)mm Hg、(83.6±8.7)次/min,明显低于对照组[(94.4±9.4)、(80.1±8.1)、(80.8±6.5)mm Hg、(89.1±9.3)次/min],差异均有高度统计学意义(t=2.35、3.40、2.37、2.48,均P<0.01)。观察组苏醒时间为(13.36±2.42)min,拔管时间为(12.53±3.61)min,明显低于对照组[(20.28±3.81)、(19.16±4.64)min],差异均有高度统计学意义(t=8.99、6.50,均P<0.01)。观察组术后苏醒质量评分[(4.26±0.53)分]明显高于对照组[(3.72±0.46)分],差异有高度统计学意义(t=4.41,P<0.01)。结论:舒芬太尼复合丙泊酚麻醉方式用于OPCABG手术较芬太尼维持血流动力学稳定性好,苏醒快,质量佳。Objective： To contrast and observe the influence of Sufentanil combined with Propofol and Fentany for the awakening and hemodynamics during vivification.Methods： 66 patients with off pump coronary artery bypass grafting surgery（OPCABG） who were elective time for the operation were randomly divided into observation group（34 cases） and concrol group（32 cases）.During the operation,observation group was used Sufentanil combined with Propofol to maintain anesthesia,control group was used Fentanyl to maintain anesthesia.All patients were constantly monitored SBP,DBP,MAP,HR,SpO2,and the vivification time,decannulation time and observers assessment of the alertness/sedation scale（OAA/S） were recorded.Results： When intubation was carried out,the scores of SBP,DBP,MAP,HR were（89.1 ±8.9）,（74.9±3.6）,（76.7±7.5） mm Hg,（83.6±8.7） times/min respectively in the observation group,lower than those of control group [（94.4±9.4）,（80.1±8.1）,（80.8±6.5） mm Hg,（89.1±9.3） times/min],the differences were significant（t=2.35,3.40,2.37,2.48,all P0.01）.The scores of vivification time [（13.36±2.42） min] and decannulation time [（12.53±3.61） min] in the observation group were lower than those of control group [（20.28±3.81）,（19.16±4.64） min]（t=8.99,6.50,P0.01）.The score of OAA/S [（4.26±0.53） points] in the observation group was higher than that of control group [（3.72±0.46） points],the differences were significant（t=4.41,P0.01）.Conclusion： The anesthesia way of Sufentanil combined with Propofol used into OPCABG surgery has better stability,faster awakening and better quality in maintaining hemodynamics than Fentanyl.

关 键 词：舒芬太尼 丙泊酚 芬太尼 血液动力学 苏醒质量 

分 类 号：R614[医药卫生—麻醉学]