瑞芬太尼靶控输注与舒芬太尼靶控输注在老年胃癌患者腹腔镜胃癌根治术中的麻醉效果比较  

Comparison of anesthesia effects of target-controlled infusion of remifentanil and target-controlled infusion of sufentanil in laparoscopic radical gastrectomy for gastric cancer in elderly patients

作　　者：温泉 张军[1] 叶园园 Wen Quan;Zhang Jun;Ye Yuanyuan(Department of Anesthesia,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院麻醉科,南阳473000

出　　处：《中国实用医刊》2024年第3期45-48,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较瑞芬太尼靶控输注与舒芬太尼靶控输注在老年胃癌患者腹腔镜胃癌根治术(LRG)中的麻醉效果。方法随机对照研究。抽取2017年5月至2020年4月于南阳市中心医院行LRG的老年胃癌患者96例,按照随机数字表法分为对照组与观察组,每组48例。对照组采用瑞芬太尼靶控输注麻醉,观察组采用舒芬太尼靶控输注麻醉。比较两组麻醉恢复情况,比较两组麻醉前(T0)、麻醉诱导后(T1)、麻醉结束时(T2)及麻醉后24 h(T3)的血流动力学指标[心率、平均动脉压(MAP)]、应激反应指标[皮质醇(COR)、谷氨酰胺(GLU)],比较两组不良反应发生率。结果观察组苏醒时间、拔管时间短于对照组(P<0.05)。T1、T2时,观察组心率低于对照组、MAP水平高于对照组,且观察组心率、MAP水平变化幅度小于对照组(P<0.05)。T1、T2、T3时,观察组COR、GLU水平低于对照组,且COR、GLU水平变化幅度小于对照组(P<0.05)。观察组不良反应发生率(4.17%,2/48)低于对照组(18.75%,9/48),P<0.05。结论与瑞芬太尼相比,舒芬太尼靶控输注在老年胃癌患者LRG中的效果更好,能缩短患者苏醒时间和拔管时间,稳定血流动力学,且不会使患者产生明显的应激反应,用药安全性较高。Objective To compare the anesthesia effects of target-controlled infusion of remifentanil and target-controlled infusion of sufentanil in laparoscopic radical gastrectomy(LRG)for gastric cancer in elderly patients.Methods A total of 96 elderly gastric cancer patients who underwent LRG in Nanyang Central Hospital from May 2017 to April 2020 were selected for the randomized controlled study.And they were divided into a control group and an observation group using a random number table method,with 48 cases in each group.The control group received target-controlled infusion of remifentanil for anesthesia,and the observation group received target-controlled infusion of sufentanil for anesthesia.The recovery of anesthesia of the two groups were compared.The hemodynamic indexes,including heart rate and mean arterial pressure(MAP),stress response indexes,including cortisol(COR)and glutamine(GLU),before anesthesia(T0),after anesthesia induction(T1),at the end of anesthesia(T2)and 24 hours after anesthesia(T3)were compared between the two groups.The incidence of adverse reactions of the two groups were compared.Results The recovery time and extubation time of the observation group were shorter than those of the control group(P<0.05).At T1 and T2,the observation group had lower heart rate and higher level of MAP,compared with the control group(P<0.05);while the amplitude of changes in heart rate and MAP level in the observation group were smaller than those in the control group(P<0.05).At T1,T2,and T3,the observation group had lower levels of COR and GLU compared with the control group,and the changes in levels of COR and GLU in the observation group at T1,T2 and T3 were smaller than those in the control group(P<0.05).The incidence of adverse reactions in the observation group(4.17%,2/48)was lower than that in the control group(18.75%,9/48),P<0.05.Conclusions Compared with remifentanil,target-controlled infusion of sufentanil has a better anesthesia effect in LRG for gastric cancer in elderly patients.It can shorten the rec

关 键 词：舒芬太尼 瑞芬太尼 胃癌根治术 靶控输注 

分 类 号：R735.2[医药卫生—肿瘤] R614[医药卫生—临床医学]