舒芬太尼与芬太尼对全身麻醉诱导老年腹部手术患者应激反应的影响  

Effects of Sufentanil and Fentanyl on Stress Reactions of Elderly Patients Undergoing Abdominal Surgery Induced by General Anesthesia

作　　者：王薇[1] 汪惠[1] 范晓华[1] 

机构地区：[1]第二军医大学长海医院麻醉科,上海200433

出　　处：《解放军医药杂志》2016年第6期109-112,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨舒芬太尼与芬太尼对全身麻醉诱导老年腹部手术患者循环系统和应激反应的影响。方法回顾性分析2012年12月—2014年12月84例全身麻醉腹部手术患者的临床资料,依据不同麻醉诱导药物分为舒芬太尼组(SF组)42例和芬太尼组(F组)42例。比较两组麻醉诱导前(T0)、气管插管前(T1)、气管插管后1 min(T2)、气管插管后5 min(T3)平均动脉压(MAP)、心率(HR)、血浆去甲肾上腺素(NE)、肾上腺素(E)变化,记录两组术中循环波动调控次数、术后24 h镇痛药物用药剂量及术后6 h和12 h视觉模拟评分(VAS)变化。结果与F组对比,SF组T2时MAP较低,HR较高(P<0.05);T3时MAP升高,HR降低(P<0.05);T1、T2时NE和E降低(P<0.05);SF组循环波动调控次数以及术后24 h镇痛药物用药剂量均较少(P<0.05);SF组术后6 h和12 h VAS评分明显降低(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论与芬太尼相比,舒芬太尼镇痛效果确切,能够维持血流动力学稳定,减轻术中应激反应。Objective To investigate effects of Sufentanil and Fentanyl on circulatory system and stress reactions of elderly patients undergoing abdominal surgery induced by general anesthesia. Methods Clinical data of 84 patients underwent abdominal surgery induced by general anesthesia between December 2012 and December 2014 was retrospectively analyzed. The patients were divided into Sufentanil group（ SF group,n = 42） and Fentanyl（ F group,n = 42） according to different drugs for anesthesia induction. Changes of mean arterial pressure（ MAP）,heart rate（ HR）,plasma norepinephrine（ NE） and epinephrine（ E） were compared before anesthesia induction（ T0）,before tracheal intubation（ T1）,1 min after tracheal intubation（ T2） and 5 min after tracheal intubation（ T3） in the two groups. The cyclical movement regulation times during operation,dosage of analgesic drugs 24 h after operation and changes of visual analogue score（ VAS） 6 h and 12 h after operation were recorded in the two groups. Results Compared with those in F group,in SF group,MAP level was lower,while HR level was higher at T2（ P〈0. 05）; MAP level increased,while HR level decreased at T3（ P〈0. 05）; NE and E levels decreased at T1 and T2（ P〈0. 05）; the cyclical movement regulation times and dosage of analgesic drugs 24 h after operation were less（ P〈0. 05）; VAS values significantly decreased 6 h and 12 h after operation（ P〈0. 05）. There was no significant difference in incidence rate of adverse reaction in the two groups（ P〈0. 05）. Conclusion Sufentanil has better analgesic effect,and it can better maintain hemodynamic stability and reduce intraoperative stress reactions compared with those by Fentanyl.

关 键 词：麻醉 全身 舒芬太尼 芬太尼 应激反应 循环系统 

分 类 号：R614.2[医药卫生—麻醉学]