舒芬太尼在非体外循环冠脉搭桥术应用中的临床研究

Application of sufentanil anesthesia in patients undergoing off-pump coronary artery bypass graft surgery

目的观察舒芬太尼在非体外循环冠状动脉搭桥手术应用中的安全性和有效性。方法择期行OPCABG病人54例，被随机分成两组，舒芬太尼组和芬太尼组，每组27例，麻醉诱导应用丙泊酚1mg/kg～2mg/kg，同时分别静注舒芬太尼0．5μg/kg～1μg/kg，或芬太尼4μμg/kg-8μg/kg，同时吸入安氟醚维持麻醉，持续输注舒芬太尼0．08μg·kg^-1·min^-1，或芬太尼0．6μg·k^-1·min^-1。记录各组气管插管、切片、麻醉维持和拨除气管导管各时间的收缩压和舒张压。结果在气管插管过程中，浅麻醉反应的病人数舒芬太尼组明显低于芬太尼组，在气管插管切皮，麻醉维持和拔管期间，芬太尼组收缩压、舒张压明显高于舒芬太尼组，术后清醒和拔管时间两组病人无统计学差异。结论舒芬太尼的麻醉效果优于芬太尼，舒芬太尼能提供术中更稳定的血液动力学。

Objective To compare the efficacy and safety of sufentanil and fentanyl anesthesia in patients undergoing off-pump coronary artery bypass graft surgery. Methods Forty patients were evenly randomized into sufentanil group and fentanyl group. Anesthesia was induced with propofol （ 1 mg/kg-2 mg/kg） and either sufentanil （ 1 μg/kg-2 μg/kg） or fentanyl （5 μg/kg-10 μg,/kg）, and was maintained with inhalation of enflurence and continuous infusion of either sufentanil （0.04 μg·kg^-1·min^-1） or fentanyl （0. 2 μg ·kg^-1·min^-1 ）. Results Light anesthesia responses during intubation and the maintenance of anesthesia was significantly less observed in sufentanil group than that in fentanyl group. Both systolic and diastolic blood pressures were ＇significantly lower during intubation, skin incision, maintenance of anesthesia and extubation in sufentanil group than those in fentanyl group. The time to opening eyes on command and the time for extubation after surgery were comparable between the two groups. Conclusion The anesthetic effects of sufentanil are more potent than those of fentanyl. Sufentanil can offer superior intraoperative hemodynamic stability in comparison to fentanyl.