瑞芬太尼联合舒芬太尼TCI对老年患者围术期应激反应及术后疼痛的影响’  

Remifentanil and sufentanil TCI on the effect of perioperative pain stress response and postoperative elderly patients

作　　者：季称心[1] 王占强[1] 詹丽春[1] 

机构地区：[1]内蒙古包头市第四医院麻醉科,内蒙古包头014030

出　　处：《世界最新医学信息文摘》2013年第15期21-22,共2页World Latest Medicine Information Electronic Version

摘　　要：目的观察瑞芬太尼联合舒芬太尼TCI对老年患者围术期应激反应及术后疼痛的影响。方法选择60例ASAI．Ⅱ级择期行腹部手术的全麻患者随机分为两组，A组和B组，每组各30例。观察并记录两组麻醉诱导前（TO）、插管前即刻（T1）、插管后lmin（T2）、开腹后lmin（T3）、及拔管后lmin（T4）患者的收缩压（SBP）、舒张压（DBP）、心率（HR）。记录两组患者术中血压、心率剧烈波动时的调控次数、术后24hVAS评分及术后24h镇痛药用量。结果与T0时比较，两组患者T1时刻MAP（平均动脉压）明显下降，HR明显减慢（P〈0．05）。B组T2～T5时刻的MAP、HR变化情况相比较A组T2～T5时刻有显著差异性（P〈0．05），B组在术中血压、心率波动的调控次数、术后24h VAS评分及术后24h镇痛药用量均明显少于A组（P〈0．05）。结论瑞芬太尼联合舒芬太尼应用于老年患者的全麻手术，能有效减少围术期的应激反应，有利于血流动力学平稳，并且避免了瑞芬太尼导致的术后痛觉过敏现象发生。Objective To observe the influence of remifentanil combined with sufentanil TCI on perioperative stress reaction and postoperative pain in elderly patients.Method Choose general anesthesia were randomly divided into 60 cases of ASA grade I - II undergoing abdominal operation into two groups, A group and B group, 30 cases in each group. The two groups were observed and recorded before induction of anesthesia （TO）, immediately before intubation （T1）, lmin after intubation （T2）, lmin after operation （T3）, and lmin after extubation （T4） in patients with systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR）. Recording control patients in the two groups of blood pressure, heart rate, fluctuation of the number of 24h after operation VAS score and postoperative analgesic dosage of 24h. Results Compared with TO, T1 in the two groups were significantly decreased at MAP, HR was significantly decreased （P 〈 0.05）. MAP, HR B T2 - T5 changes time compared to the A group ofT2 - T5 time has significant difference （P 〈 0.05）, B group in intraoperative blood pressure, heart rate fluctuations control times, postoperative 24h score of VAS and 24h postoperative analgesics were significantly less than that in A group （P 〈 0.05） Observation： Remifentanil and sufentanil in elderly patients with general anesthesia operation, can effectively reduce the stress response during perioperative period, is conducive to the stable hemodynamics, and avoid the phenomenon of remifentanil induced hvoeral^esia after operation.

关 键 词：瑞芬太尼 舒芬太尼 TCI 老年患者 应激反应及术后疼痛 

分 类 号：R614.24[医药卫生—麻醉学]