不同靶浓度瑞芬太尼在老年患者胸科手术麻醉中的临床分析  

Clinical analysis of remifentanil by different target concentrations for anesthesia in senile thoracic surgery

作　　者：盛思玉 徐凯[1] 程嫒嫒[1] 熊祥生[1] 王亚祥[1] 

机构地区：[1]江苏省淮安市淮阴医院麻醉科,223300

出　　处：《中国实用医药》2016年第33期21-23,共3页China Practical Medicine

摘　　要：目的探究不同靶浓度的瑞芬太尼在老年胸科手术患者麻醉中的应用价值,为临床提供参考。方法 87例老年胸科手术患者,根据给予瑞芬太尼浓度的不同分为4、6、8μg/L组,每组29例,对比分析三组患者麻醉时间、意识丧失时间、恢复自主呼吸时间、睁眼时间、拔管时间及不同时间段[T0(进入手术室后平卧10 min)、T1(麻醉诱导后)、T2(插管时)、T3(插管后3 min)、T4(手术切皮后)、T5(开胸探查时)、T6(手术结束)、T7(拔管)]平均动脉压(MAP)、收缩压(SBP)、心率(HR)水平。结果三组麻醉时间、意识丧失时间、恢复自主呼吸时间、睁眼时间、拔管时间比较差异无统计学意义(P>0.05)。4μg/L组在T2、T4、T5时间点的SBP、MAP、HR水平高于T0时间点,而6μg/L组和8μg/L组SBP、MAP、HR水平相对较好;8μg/L组在T1时间点的SBP、MAP、HR水平较T0时降低较为显著;6μg/L组的SBP、MAP、HR水平较其他两组较为良好。结论在老年患者的胸科手术中,使用6μg/L浓度的瑞芬太尼进行诱导麻醉可有效减轻患者在手术过程中的应激反应,增加患者手术的安全性,值得推广。Objective To investigate application value of remifentanil by different target concentrations for anesthesia in senile thoracic surgery, and to provide clinical reference. Methods A total of 87 senile thoracic surgery patients were divided by different remifentanil concentrations into 4, 6 and 8 μg/L groups, with 29 cases in each group. Comparative analysis was made on anesthesia time, unconsciousness time, autonomous respiration recovery time, eye opening time, extubation time, and mean arterial pressure（MAP）, systolic blood pressure（SBP）and heart rate（HR）levels in various time points[ T0（lying 10 min in operating room）, T1（after anesthesia induction）, T2（during intubation）, T3（3 min after intubation）, T4（after operation skin incision）, T5（during exploratory thoracotomy）, T6（operation ending）and T7（extubation）] in the three groups. Results There was no statistically significant difference of anesthesia time, unconsciousness time, autonomous respiration recovery time, eye opening time and extubation time across the three groups（P〈0.05）. 4 μg/L group had higher SBP, MAP and HR in T2, T4, T5 than those in T0, while 6 and 8 μg/L groups had relatively better SBP, MAP and HR levels. 8 μg/L group had obviously lower SBP, MAP and HR levels in T1 than those in T0, while 6 μg/L group had better SBP, MAP and HR levels than the other two groups. Conclusion Implement of remifentanil by 6 μg/L in senile thoracic surgery for induced anesthesia can effectively reduce intraoperative stress reactions and enhance safety in patients, and this method is worth promoting.

关 键 词：瑞芬太尼 胸科手术 靶浓度 

分 类 号：R614[医药卫生—麻醉学]