舒芬太尼持续泵注在老年患者妇科开腹手术麻醉中的应用

发布时间：2018-06-12 20:20

本文选题：舒芬太尼 + 持续泵注　；参考：《西部医学》2016年10期

【摘要】：目的探讨持续泵注舒芬太尼在老年妇科患者开腹手术中的安全性和有效性。方法 80例ASAⅡ-Ⅲ级择期行妇科开腹手术患者,年龄60~85岁,随机分为两组:R组40例采用瑞芬太尼6μg/kg·h;S组40例采用舒芬太尼0.1μg/kg·h。于麻醉诱导气管插管后吸入1~3%七氟烷维持麻醉,根据患者入组情况分别持续泵注瑞芬太尼和舒芬太尼,于手术结束前10分钟停止泵注镇痛药。记录患者的一般情况、生命体征变化情况,麻黄碱、阿托品的用量,记录患者术后呼吸和意识恢复情况、苏醒后的疼痛评分及患者苏醒即刻躁动的发生率。结果低血压和心率减慢的发生率在S组为37.5%和20%均低于R组的60.5%和62.5%,差异有统计学意义(P0.05);相应麻黄碱和阿托品的用量S组为(5.48±2.27)和(0.33±0.12)也明显低于R组的(12.4±3.23)和(0.81±0.13),差异有统计学意义(P0.05);呼吸恢复时间和潮气量恢复时间R组为(4.3±2.2)min和(5.6±1.5)min均短于S组的(6.3±3.4)min和(8.1±2.5)min,差异有统计学意义(P0.05);但两组意识恢复时间差异无统计学意义(P0.05);疼痛评分R组明显高于S组,分别为(6.5±2.6)分和(4.1±1.3)分(P0.05);苏醒即刻躁动发生率S组明显低于R组,分别为12.5%和55%,差异有统计学意义(P0.05)。结论舒芬太尼持续泵注具有血流动力学稳定、术后恢复快、不良反应少、镇痛作用较强等优点,可安全用于老年患者妇科开腹手术的麻醉维持。
[Abstract]:Objective to explore the safety and effectiveness of sufentanil in open surgery for elderly gynecologic patients. Methods 80 ASA II - III gynecologic open surgery patients, aged 60~85 years, were randomly divided into two groups: 40 cases in group R using remifentanil 6 g/kg h; 40 cases in group S after sufentanil 0.1 g/kg. H. after anesthesia induction tracheal intubation 1~3% seven halothane was inhaled to maintain anesthesia. The patients were pumped by sufentanil and sufentanil, respectively, and 10 minutes before the operation. The general condition of the patients, the changes of vital signs, the dosage of ephedrine, atropine, the recovery of postoperative respiration and consciousness, and the pain evaluation after awakening were recorded. The incidence of hypotension and heart rate slowing in patients with hypotension and heart rate slowed in S group was 37.5% and 20% lower than that in group R, 60.5% and 62.5%, and the difference was statistically significant (P0.05); the corresponding dosage of ephedrine and atropine was (5.48 + 2.27) and (0.33 + 0.12) was significantly lower than that of group R (12.4 + 3.23) and (0.81 + 0.13), and the differences were Statistical significance (P0.05); R group (4.3 + 2.2) min and (5.6 + 1.5) min were shorter than those of S group (6.3 + 3.4) min and (8.1 + 2.5) min, and the difference was statistically significant (P0.05), but there was no significant difference in the recovery time of the two groups (P0.05), and the pain score in R group was significantly higher than that of S group (6.5 + 2.6) and 4. (4.), respectively. 1 + 1.3) score (P0.05). The incidence of immediate restlessness in S group was significantly lower than that of group R, 12.5% and 55%, respectively. The difference was statistically significant (P0.05). Conclusion sufentanil continuous pump has a stable hemodynamics, quick recovery, less adverse reaction and stronger analgesic effect. It can be used safely for the maintenance of anesthesia in elderly patients with gynecologic open surgery.
【作者单位】：四川大学华西第二医院麻醉科·出生缺陷与相关妇儿疾病教育部重点实验室;
【基金】：四川省科技厅应用基础项目(2014YJ0081) 成都市科技局(2014-HM01-00043-SF)
【分类号】：R614

【相似文献】