瑞芬太尼复合丙泊酚靶控输注在超快通道心脏麻醉中的应用  

Application of Target Controlled Infusion of Remifentanil Combined with Propofol in Ultrafast Channel Cardiac Anesthesia

作　　者：王鹤 叶芹芬 尹忠美 孙林凤 杨玲梅 王文法 WANG He;YE Qinfen;YIN Zhongmei;SUN Linfeng;YANG Lingmei;WANG Wenfa(Chuxiong Yi Autonomous Prefecture People's Hospital,Chuxiong 675000,China;不详)

机构地区：[1]楚雄彝族自治州人民医院,云南楚雄675000

出　　处：《中外医学研究》2023年第6期14-17,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨瑞芬太尼复合丙泊酚靶控输注在超快通道心脏麻醉中的应用效果。方法:选择2019年3月—2020年12月在楚雄彝族自治州人民医院行心脏手术的68例患者作为研究对象。根据随机数表法分为观察组与对照组,各34例。观察组采用瑞芬太尼复合丙泊酚靶控输注超快通道心脏麻醉,对照组采用舒芬太尼复合丙泊酚输注心脏麻醉。比较两组体外循环时间、术后拔管时间、ICU停留时间、不良反应发生情况、术后疼痛评分及警觉/镇静观察评分(OAA/S)。结果:两组体外循环时间比较,差异无统计学意义(P>0.05)。观察组术后拔管时间及ICU停留时间均短于对照组,差异有统计学意义(P<0.05)。对照组不良反应发生率明显高于观察组,差异有统计学意义(P<0.05)。对照组在各时点疼痛评分低于观察组,差异有统计学意义(P<0.05)。对照组OAA/S评分明显低于观察组患者,差异有统计学意义(P<0.05)。结论:舒芬太尼复合丙泊酚麻醉与瑞芬太尼复合丙泊酚麻醉在超快通道心脏麻醉中均有较好的麻醉效果,两种方式各有优点,舒芬太尼复合丙泊酚麻醉患者术后的疼痛程度相对要低,而瑞芬太尼复合丙泊酚醉中能有效缩短患者术后气管拔管时间及ICU停留时间,并能降低术后不良反应的发生率,相对来说是一种更为安全的麻醉方式。Objective:To explore the effect of target controlled infusion of Remifentanil combined with Propofol in ultrafast channel cardiac anesthesia.Method:A total of 68 patients who underwent cardiac surgery in Chuxiong Yi Autonomous Prefecture People's Hospital from March 2019 to December 2020 were selected as the study subjects.According to the random number table method,they were divided into observation group and control group,34 cases in each group.The observation group was anesthetized with Remifentanil combined with Propofol target controlled infusion ultrafast channel,and the control group was anesthetized with Sufentanil combined with Propofol infusion.The time of extracorporeal circulation,extubation time after operation,ICU stay time,adverse reactions,postoperative pain rating and observer's assessment of alertness/sedation(OAA/S)were compared between the two groups.Result:There was no significant difference in the time of cardiopulmonary bypass between the two groups(P>0.05).The extubation time and ICU stay time in the observation group were shorter than those in the control group(P<0.05).The incidence of adverse reactions in the control group was significantly higher than that in the observation group,and the differences were statistically significant(P<0.05).The pain score of the control group at each time point were lower than those of the observation group,and the differences were statistically significant(P<0.05).The OAA/S score of the control group was significantly lower than that of the observation group,the difference was statistically significant(P<0.05).Conclusion:Both Sufentanil combined with Propofol anesthesia and Remifentanil combined with Propofol anesthesia have good anesthetic effect in ultrafast channel cardiac anesthesia.Both methods have their advantages,the postoperative pain degree of Sufentanil combined with Propofol anesthesia patients is relatively low,while Remifentanil combined with Propofol can effectively shorten the postoperative tracheal extubation time and ICU stay time of pa

关 键 词：超快通道 瑞芬太尼 丙泊酚 靶控输注 疼痛 

分 类 号：R614[医药卫生—麻醉学]