舒芬太尼与芬太尼对老年腹腔镜胆囊切除术患者苏醒质量影响比较  

Comparison of the Quality of Recovery in Elder Laparoscopic Cholecystectomy Patients under General Anesthesia Maintained by Sufentanil and Fentanyl

作　　者：彭庆玲 邵景汉[2] 郑炳堂 张凯[3] 

机构地区：[1]慈溪协和医院麻醉科,浙江慈溪315301 [2]宁波市第一医院麻醉科 [3]宁波市医疗中心李惠利医院麻醉科

出　　处：《药物流行病学杂志》2014年第12期707-709,715,共4页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:比较舒芬太尼、芬太尼对老年腹腔镜胆囊切除术患者苏醒质量的影响。方法:择期行腹腔镜胆囊切除术的老年患者60例随机分为舒芬太尼组(S组)、芬太尼组(F组),每组30例。分别以舒芬太尼0.4μg·kg-1或芬太尼4μg·kg-1,联合咪达唑仑、维库溴铵、丙泊酚诱导插管。手术结束前20 min,S组静注舒芬太尼10μg,F组静注芬太尼0.1 mg。观察两组患者围拔管期的血流动力学指标、拔管时间、拔管后5min的视觉模拟评分(VAS)及全麻恢复期药品不良反应发生情况,与术后要求镇痛治疗的患者例数。结果:两组患者拔管时收缩压、舒张压、心率均较麻醉前明显升高(P<0.01),拔管后10 min F组血压改变较S组更剧烈(P<0.01)。与F组相比,S组的拔管时间缩短,VAS评分降低(P<0.01);躁动、呛咳、心血管事件和呼吸抑制等应激反应以及术后30 min要求镇痛治疗的患者例数均明显低于F组(P<0.05)。S组药品不良反应发生率明显低于F组(P<0.01)。结论:舒芬太尼用于全身麻醉维持时患者术后置管时间短,镇痛效果显著,术后疼痛发生率低;能提供更平稳的血流动力学环境,减少患者苏醒期疼痛及不良反应的发生。Objectlve：To compare the quality of recovery in elder laparoscopic cholecystectomy patients under general anesthesia maintained by sufentanil and fentanyl. Methods ： Sixty elder patients with selective laparoscopic eholecys- tectomy were randomly divided into 2 groups ： sufentanil group（ Group S） and fentanyl group（ Group F）. Anesthesia was inducted with sufentanil 0.4 g · kg-1 （ group S） or fentanyl 4g · kg-1 （ group F） , midazolam 0.1 g · kg-1 , veeuronium 0.12 mg · kg-1 , propofol 2 mg · kg-1. Sufentanil 10 g （group S） or fentanyl 0. lmg（group F） was injected 20rain before the end of operation. Hemodynamies parameters during the period of tracheal extubation, the time of tracheal extubation, the incidence of postoperative pain , the untoward effects as well as the number of patients asking for analgesic therapy were investigated. Results：During the period of tracheal extubation, the systolic blood pressure , diastolic blood pressure and heart rate were higher than before anesthesia（P 〈 0.01 ）. The systolic blood pressure ,diastolic blood pressure in group F were higher than those in group S（ P 〈 0.01 ）. Compared with group F, the time of tracheal extubation in group S was shor- ter, VAS score was lower（ P 〈 0.01 ） , both the rate of untoward effects and the number of patients asking for analgesic therapy was much fewer（ P 〈 0. 05 ）. The incidence of adverse drug reactions in S group was much lower than inthe F group（ P 〈 0.01 ）. Conclusion：Using sufentanil in elder laparoscopic cholecystectomy patients under general anesthesia provides a shorter time of tracheal extubation with a lower rate of postoperative pain , a more stable hemodynamic environment, and a lower rate of untoward effects postoperation.

关 键 词：舒芬太尼 芬太尼 腹腔镜胆囊切除术 老年患者 苏醒质量 

分 类 号：R971.2[医药卫生—药品]