靶控输注舒芬太尼在重症冠心病患者不停跳冠脉旁路移植术中的应用  

Application of target-controlled infusion of sufentanil in severe coronary artery disease patients undergoing off-pump coronary artery bypass

作　　者：赵石磊[1] 刁玉刚[1] 张铁铮[1] 李林[1] 

机构地区：[1]沈阳军区总医院麻醉科,沈阳110840

出　　处：《实用药物与临床》2013年第11期997-1000,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的 研究靶控输注舒芬太尼用于重症冠心病患者不停跳冠脉旁路移植术（OPCAB）的麻醉效果.方法 30例择期行OPCAB的重症冠心病患者随机分成3组,给予静脉快速诱导气管插管,七氟醚吸入维持麻醉,A组及B组在相应时点分次给予舒芬太尼（总剂量2.4 μg/kg或4.4 μg/kg）,C组采用BOVILL模型靶控输注舒芬太尼（目标效应室浓度0.8 ng/mL）.记录各时点血流动力学指标及BIS值,对上述指标、术后脱离呼吸机时间以及术后ICU停留时间进行统计学分析.结果 与T0比较,C组患者在T1 ～ T9的HR、MAP、BIS值变化程度均小于A、B两组（P＜0.05）,A组患者联合应用血管活性药用量大于B、C两组（P＜0.05）.三组患者均未发现围术期不良反应,术后脱离呼吸机时间以及ICU停留时间差异无统计学意义（P＞0.05）.结论 靶控输注舒芬太尼用于重症冠心病患者OPCAB可提供较稳定的血流动力学,对患者术后脱呼吸机时间及ICU停留时间无影响.Objective To investigate the effect of target controlled infusion of sufentanil in severe coronary ar- tery disease patients undergoing off-pump coronary artery bypass （OPCAB）. Methods 30 patients with severe coro- nary artery disease scheduled for OPCAB were randomly divided into three groups. Under general anaethesia maintained with sevoflurane inhalation, sufentanil doses 2.4 μg/kg （group A） ,4. 4 μg/kg （group B ） or target-controlled infusion with fixed concentration of 0. 8 ng/mL （group C） were given respectively. Hemodynamic changes and BIS values were recorded. Statistical analysis was made about the postoperative mechanical ventilation time and ICU duration. Results Compared with group A and group B,the changes of HR,MAP,BIS values from T1 to T9 in group C were more slight （ P 〈 0.05 ）. More vasoactive medicines were needed in group A than group B and group C （ P 〈 0. 05 ）. The postopera-tive mechanical ventilation time and the ICU duration showed no significant difference among the three groups （P 〉 0. 05 ）. Conclusion Target-controlled infusion of sufentanil for severe coronary artery disease can provide hemody- namic stability in OPCAB, with no impact on postoperative mechanical ventilation time and ICU duration.

关 键 词：舒芬太尼 靶控输注 不停跳冠脉旁路移植术 

分 类 号：R614[医药卫生—麻醉学]