老年胸外科手术中不同浓度的瑞芬太尼的临床麻醉效果分析  

Clinical Anaesthesia Effect Analysis of Remifentanil with Different Concentration in Elderly Thoracic Surgery

作　　者：胡兵 宋伟 HU Bing;SONG Wei(Department of AnesthesiaⅡ,Zhangzhou Zhengxing Hospital,Zhangzhou,Fujian 363000,China)

机构地区：[1]漳州正兴医院麻醉二科,福建漳州363000

出　　处：《中国医药指南》2025年第7期90-92,共3页Guide of China Medicine

摘　　要：目的 探讨老年患者接受胸外科手术治疗时,在麻醉过程中使用不同浓度瑞芬太尼的麻醉效果。方法 选取2023年4月至2024年4月于漳州正兴医院胸外科接受手术治疗的老年患者80例,以随机数字表法分成A、B两组,A组瑞芬太尼用量为6μg/L,B组瑞芬太尼用量为8μg/L,对比麻醉效果、麻醉前后患者临床检测指标变化情况、手术相关指标及血浆肾上腺素(E)、去甲肾上腺素(NE)水平变化情况。结果 A组麻醉总有效率高于B组(P <0.05);麻醉后5 min,A组血氧饱和度、收缩压、心率和平均动脉压均高于B组(均P <0.05);两组意识丧失时间无差异(P> 0.05);A组自主呼吸恢复时间、呼之睁眼时间、拔管时间均低于B组(均P <0.05);麻醉前对比E、NE水平,两组差异无统计学意义(P> 0.05),两组患者在气管插管时的E及NE水平比麻醉前有所上升(P <0.05);两组组间对比,差异均无统计学意义(均P> 0.05)。结论 对于接受胸外科手术治疗的老年患者而言,使用瑞芬太尼进行麻醉时,给予6μg/L的用量可获得更为理想的麻醉效果,且对患者生命体征相关指标影响更小,术后麻醉恢复更快。Objective To investigate the anesthetic effect of remifentanil with different concentrations in the process of anesthesia in elderly patients undergoing thoracic surgery.Methods A total of 80 elderly patients who received surgical treatment in the Department of Thoracic Surgery of Zhangzhou Zhengxing Hospital from April 2023 to April 2024 were selected and divided into two groups by random number table method.The dosage of remifentanil in group A was 6μg/L,and that in group B was 8μg/L.The effects of anesthesia,changes of clinical indicators before and after anesthesia,surgical indicators,and changes of plasma epinephrine(E)and suprynothyroid gland(NE)levels were compared.Results The total effective rate of anesthesia in group A was higher than that in group B(P<0.05).Blood oxygen saturation,systolic blood pressure,heart rate and mean arterial pressure in group A were higher than those in group B at 5min after anesthesia(all P<0.05).There was no difference in the time of loss of consciousness between the two groups(P>0.05).The recovery time of spontaneous respiration,eye opening time and extubation time of group A were lower than those of group B(all P<0.05).Before anesthesia,there was no significant difference in E and NE levels between the two groups(P>0.05),and the E and NE levels of the two groups were increased during endotracheal intubation compared with those before anesthesia(P<0.05).There was no significant difference between the two groups(all P>0.05).Conclusions For elderly patients undergoing thoracic surgery,when using remifentanil for anesthesia,the dosage of 6μg/L can obtain more ideal anesthetic effect,and has less influence on the relevant indicators of patients’vital signs,and faster recovery from anesthesia after surgery.

关 键 词：老年 胸外科 手术 瑞芬太尼 浓度 麻醉效果 

分 类 号：R614[医药卫生—麻醉学] R655[医药卫生—外科学]