瑞芬太尼应用于不停跳冠状动脉旁路移植术加速康复外科效果的观察  

Clinical observation of remifentanil used in off-pump coronary artery bypass grafting in enhanced recovery after surgery

作　　者：车昊[1] 赵丽云[1] CHE Hao;ZHAO Liyun(Department of Anesthesiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉科,100029

出　　处：《心肺血管病杂志》2021年第6期597-599,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:对瑞芬太尼在不停跳冠状动脉旁路移植术(OPCABG)加速康复外科(ERAS)中效果进行临床观察。方法:对我院2019年7月至2020年7月,施行的OPCABG患者120例行进行研究,分为对照组(舒芬太尼麻醉维持组)60例和观察组(瑞芬太尼麻醉维持组)60例。观察比较两组患者在以下7个时间点的血流动力学变化,包括入室时(T0)、麻醉诱导后(T1)、手术切皮时(T2)、CABG时(T3)、手术结束时(T4)、术后清醒(T5)、拔除气管导管时(T6)的收缩压、舒张压、心率等结果。比较两组患者手术时间、术中入液量、出血量、尿量、术中去甲肾上腺素的用量及术后苏醒时间、拔除气管导管的时间。结果:在T0~T6各时间点,收缩压、舒张压、心率等两组患者组间比较差异无统计学意义(P>0.05)。两组患者手术时间、术中入液量、出血量、尿量及术中去甲肾上腺素用量比较,差异无统计学意义(P>0.05)。观察组患者较对照组术后苏醒时间更短、拔除气管导管时间更短,差异有统计学意义(P<0.05)。结论:瑞芬太尼用于OPCABG中麻醉效果理想,药物能够快速代谢,使患者快速恢复,到达ERAS的目的。Objective:To study the clinical observation of remifentanil in enhanced recovery after sur-gery(ERAS)after off-pump coronary artery bypass surgery(OPCABG).Methods:120 patients with coronary heart disease who underwent OPCABG in our hospital from July 2019 to July 2020 were studied.They were divided into control group(sufentanil)and observation group(remifentanil),60 cases in each group.Observe the effect of anesthesia.Results:There were no significant differences in intraoperative blood pressure and heart rate between the observation group and the control group,and there was no statistical significance(P>0.05).There was no significant difference in the dosage of vasoactive drugs in the observation group,and there was no statistical significance in the comparison(P>0.05).There were significant differences in surgical indexes between the two groups(P<0.05).Conclusions:The anesthetic effect of remifentanil in OPCABG is ideal,and the drug can promote the rapid recovery of patients,and realize the concept of ERAS.

关 键 词：瑞芬太尼 舒芬太尼 不停跳冠状动脉旁路移植术 加速康复外科效果 

分 类 号：R54[医药卫生—心血管疾病]