瑞芬太尼对老年全麻患者血流动力学及血液流变学的影响观察  

Effect of Remifentanil on Hemodynamics and Hemorheology in Elderly Patients with General Anesthesia

作　　者：孙坤 SUN Kun(Benxi Central Hospital,Benxi 117000,China)

机构地区：[1]辽宁省本溪中心医院,辽宁本溪117000

出　　处：《中国医学创新》2018年第9期9-13,共5页Medical Innovation of China

摘　　要：目的:探讨瑞芬太尼对于老年全麻患者的血流动力学和血液流变学指标的影响。方法:回顾性分析2014年12月-2016年3月本院全麻手术患者200例的临床资料。根据麻醉药使用情况将其分为观察组(使用瑞芬太尼全麻)和参照组(使用枸橼酸舒芬太尼注射液全麻),各100例。比较两组镇静(Ramsay评分)、镇痛(VAS评分)效果,麻醉前后的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)、血氧饱和度(oxygen saturation,Sp O_2)、全血还原黏度、血浆还原黏度和红细胞聚集指数。结果:麻醉诱导后10 min,观察组Ramsay评分低于参照组(P<0.05);拔管后6、12、24 h,观察组VAS评分均低于参照组,比较差异均有统计学意义(P<0.05);麻醉诱导完成即刻(T_1),两组HR、MAP和Sp O_2均低于麻醉诱导前(T_0),且参照组均低于观察组,比较差异均有统计学意义(P<0.05);麻醉诱导后60 min,两组全血还原黏度、血浆还原黏度和红细胞聚集指数均低于麻醉前,且参照组均低于观察组,比较差异均有统计学意义(P<0.05);麻醉前后,观察组血流动力学和血液流变学指标的波动幅度均小于参照组。结论:老年全麻手术中应用瑞芬太尼不仅麻醉效果佳,而且对血流动力学和血流变学干预小,麻醉安全性更好。Objective:To investigate the effect of Remifentanil on hemodynamics and hemorheology in elderly patients with general anesthesia.Method:The clinical data of 200 patients with general anesthesia in our hospital from December 2014 to March 2016 were analyzed retrospectively.According to the use of anesthetics,they were divided into observation group(general anesthesia with Remifentanil)and reference group(general anesthesia with Sufentanil Citrate Injection),100 cases in each group.The effect of sedation(Ramsay score)and analgesic(VAS score),the heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO2),whole blood reduction viscosity,plasma reduction viscosity and erythrocyte aggregation index before and after anesthesia between two groups were measured.Result:After anesthesia induction 10 min,the Ramsay score of observation group was lower than that of reference group(P<0.05),and after extubation 6,12,24h,the VAS scores of observation group were lower than those of reference group,the differences were statistically significant(P<0.05).After anesthesia induction immediately(T1),the HR,MAP and SpO2 in two groups were all lower than those of before anesthesia induction(T0),and the reference group were lower than those of observation group,the differences were statistically significant(P<0.05).After anesthesia induction 60 min,the whole blood reduction viscosity,plasma reduction viscosity and erythrocyte aggregation index of two groups were all lower than those before anesthesia,and the reference group were lower than those of observation group,the differences were statistically significant(P<0.05).Before and after anaesthesia,the fluctuation amplitude of hemodynamics and hemorheology indexes in observation group were less than those of reference group.Conclusion:The application of remifentanil anesthesia in the elderly during general anesthesia is not only good effects,but also the intervention of hemodynamics and hemorheology is small,and the safety of anesthesia is better.

关 键 词：瑞芬太尼 老年 全身麻醉 血流动力学 血液流变学 

分 类 号：R614.2[医药卫生—麻醉学]