瑞米芬太尼对肺癌根治术患者术中房颤发生率的影响

Effect of Continuous Remifentanil Administration on Incidence Rate of Intra-Operative Atrial Fibrillation in Patients Undergoing Radical Operation for Lung Cancer

目的:研究瑞米芬太尼对肺癌根治术患者术中房颤的影响。方法:通过麻醉信息系统选择2008年1月—2011年3月记录完整的肺癌根治术患者的麻醉记录单。依据是否应用瑞米芬太尼分为瑞芬组和非瑞芬组。2组患者采用相同的静脉麻醉诱导方法。瑞芬组在麻醉诱导后开始予瑞米芬太尼0.1～0.2μg/(kg·min)。非瑞芬组麻醉维持采用间断静脉注入芬太尼。统计2组患者房颤的发生率,根据不同性别、不同年龄进行分层比较。结果:与非瑞芬组比较,瑞芬组患者术中房颤发生率均有降低趋势,总体房颤发生率下降1.01%,其中男性和女性患者中降低幅度均为1.2%。老年患者中降低幅度为2.2%:其中老年男性患者中降低幅度为2.8%,老年女性患者中降低幅度为2.2%。年轻患者中降低幅度轻微。结论:瑞米芬太尼有降低肺癌根治术中房颤发生率的趋势,在老年男性患者中较明显。

Objective：To investigate the effects of continuous remifentanil administration on incidence rate of intra-operative atrial fibrillation in patients undergoing radical operation for lung cancer.Methods：Anesthesia records in patients undergoing radical operation for lung cancer between Jan.2008 and Mar.2011 were collected from electrical anesthesia recording system in our hospital.A total of 3058 patients＇ anesthesia recods med our criterion were analyzed.Those patients were divided into 2 groups：Remifentanil group and Non-remifentanil group.Remifentanil with a dose of 0.1-0.2μg/kg/min was continuously adiminstrated after anesthesia induction was completed in the Remifentanil group.Fentanyl was administrated intermittently according to anesthesia level requirement in the Non-remifentanil group.The incidence rate of atrial fibrillation was analyzed in both groups.Results：There was a descreasing tendency about the incidence rates of intra-operative atrial fibrillation for patients in Remifentanil group comparing with that in Non-remifentanil group.The total incidence rates of intra-operative atrial fibrillation descreased from 5.25%in patients of the Non-remifentanil group to 4.24%in those of the Remifentanil group.The descreasing extent of the incidence rate of intra-operative atrial fibrillation in male and female patients arrived at 1.2%,2.2% in the old patient group,2.8%in the older male patient group,2.2%in the older female patients group.Conclusions：A descreasing tendency about the incidence rates of intra-operative atrial fibrillation was observed in patients with remifentanil continuously administrated during operation comparing with in patients with no remifentanil administrated,especially in older male patients.