瑞芬太尼麻醉维持在非体外循环下冠脉搭桥术中的应用及对ECG、SpO_(2)影响  

The Application of Remifentanil Anesthesia Maintenance in Off-pump Coronary Artery Bypass Grafting and its Effect on ECG and SpO_(2)

作　　者：邓群 姜晶晶 王俊伟 魏金聚[1] DENG Qun;JIANG Jingjing;WANG Junwei;WEI Jinju(Department of Anesthesiology,the 7th People’s Hospital of Zhengzhou,Zhengzhou 450016,Henan,China)

机构地区：[1]郑州市第七人民医院麻醉科,河南郑州450016

出　　处：《中国药物滥用防治杂志》2023年第8期1329-1333,共5页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨瑞芬太尼麻醉维持在非体外循环下冠脉搭桥术(OPCABG)中的应用及对心电图(ECG)、血氧饱和度(SpO_(2))影响。方法:选取2022年1月—2022年9月我院收治的82例OPCABG患者,应用随机数字表法将其分为观察组与对照组,每组41例。所有患者均采取静脉全身麻醉,对照组予以常规七氟醚吸入+静脉注射舒芬太尼进行麻醉维持,观察组持续泵注丙泊酚+瑞芬太尼麻醉维持,比较两组生命体征、麻醉效果、苏醒质量,ECG诊断结果以及术后疼痛程度。结果:观察组T_(1)~T_(4)时间SPO_(2)、HR、MAP、DBP、SBP比较,差异无统计学意义(P>0.05),对照组T_(1)~T_(4)时间SPO_(2)、HR、MAP、DBP、SBP比较,差异有统计学意义(P<0.05);两组T_(2)、T_(3)时刻SPO_(2)、MAP、DBP、SBP比较,差异有统计学意义(P<0.05),而两组T_(1)、T_(4)时刻SPO_(2)、MAP、DBP、SBP比较,差异无统计学意义(P>0.05);两组T_(3)时刻HR比较,差异有统计学意义(P<0.05),其余时刻组间比较,差异均无统计学意义(P>0.05);两组麻醉优良率比较,差异无统计学意义(P>0.05);观察组自主呼吸恢复时间、睁眼时间、CSICU停留时间短于对照组,且观察组患者苏醒期躁动发生率低于对照组(P<0.05);术后1周观察组术后心电图变化不良人数占比低于对照组(P<0.05);观察组术后各时间点VAS评分低于对照组(P<0.05)。结论:在OPCABG中应用瑞芬太尼进行麻醉维持能够进一步稳定患者生命体征,提升麻醉效果与苏醒质量,改善术后短期ECG异常现象,降低术后疼痛程度。Objective:To explore the application of remifentanil anesthesia maintenance in off-pump coronary artery bypass grafting and its effect on ECG and SpO_(2).Methods:From January 2022 to September 2022,82 patients with off-pump coronary artery bypass grafting in our hospital were divided into observation group and control group by random number table method,with 41 cases in each group.All patients received intravenous general anesthesia;control group received routine sevoflurane inhalation and intravenous sufentanil anesthesia after induction;observation group received continuous pump propofol and remifentanil anesthesia.Vital signs,anesthetic effect,quality of recovery,ECG diagnosis,and postoperative pain were compared between the two groups.Results:There were no significant differences in SPO_(2),HR,MAP,DBP and SBP during T_(1)-T_(4) in the observation group(P>0.05),but there were significant differences in SPO_(2),HR,MAP,DBP and SBP during T_(1)-T_(4) in the control group(P<0.05).There were statistically significant differences in SPO_(2),MAP,DBP and SBP between 2 groups at time T_(2) and T_(3)(P<0.05),but no significant differences at time T_(1) and T_(4)(P>0.05).There was significant difference in HR between the two groups only at T_(3) moment(P<0.05),but there was no statistical significance at the other moments between the two groups(P>0.05).There was no significant difference in the rate of good and good anesthesia between the two groups(P>0.05).The recovery time of spontaneous respiration,eye opening time and residence time of CSICU in observation group were significantly shorter than those in control group,and the incidence of agitation during recovery was lower in observation group(P<0.05).The number of postoperative impaired ECG was significantly lower in the observation group one week after surgery(P<0.05).The VAS score of observation group was significantly lower at each time point after surgery(P<0.05).Conclusion:The use of remifentanil for anesthesia maintenance in offpump coronary artery bypass graft

关 键 词：瑞芬太尼 丙泊酚 非体外循环 冠脉搭桥术 

分 类 号：R614[医药卫生—麻醉学]