瑞芬太尼和芬太尼在冠状动脉旁路移植术麻醉中的应用

Remifentanyl Anesthesia in Off-Pump Coronary Artery Bypass Grafting

目的:比较瑞芬太尼与芬太尼在非体外循环下冠状动脉旁路移植术麻醉中的效果。方法:2008年1月-2010年6月,将40例接受非体外循环下冠状动脉旁路移植术的患者随机分为芬太尼麻醉组(芬太尼组,n=20)和瑞芬太尼麻醉组(瑞芬太尼组,n=20)。比较2组患者围术期血流动力学改变、术后恢复的情况及住院总费用。结果:瑞芬太尼组患者术中血流动力学稳定,术后患者拔管时间和出监护室时间均显著短于芬太尼组(P均<0.05),瑞芬太尼组平均住院总费用亦显著少于芬太尼组(P=0.029)。结论:将瑞芬太尼用于非体外循环下心脏外科手术的麻醉不仅是安全的,而且患者苏醒和恢复时间较短,降低了患者的住院费用。

Objective：To compare the anesthetic effect of remifentanyl and fentanyl in off-pump coronary artery bypass graf- ting. Methods：From January 2008 to June 2010,40 patients scheduled for off-pump coronary artery bypass grafting were ran domly divided into two groups according to the perioperative anesthetic drug, the fentanyl group and the remifentanyl group. The perioperative dynamic changes of blood flow, the time in intensive care unit and the hospitalization costs in the two groups were compared. Results： The dynamic changes of blood flow in the remifentanyl group were stable. The postoperative extuba- tion time and the intensive care unit time were shorter in the remifentany group than those in the fentanyl group （all P〈0.05）. The average hospitalization costs in the remifentanyl group were lower than those in the fentanyl group（P = 0. 029）. Conclu- sions： Remifentanyl is safe to be used in off-pump coronary artery bypass grafting, and the hospital costs can be reduced.