丙泊酚联合舒芬太尼靶控输注在心脏手术中的应用

Applications of Target Controlled Infusion for Propofol Combined with Sufentanil in Cardiac Surgery

目的:观察丙泊酚联合舒芬太尼靶控输注维持麻醉在心脏手术中的临床效果。方法:选择2010年1月-2012年6月在笔者所在医院择期行心脏手术患者46例,随机分为两组,每组23例。观察组采用靶控输注方式,对照组采用恒速泵注方式。观察记录入室(T1)、诱导即刻(T2)、插管即刻(T3)、劈胸骨(T4)、关胸骨(T5)时心率、平均动脉压的数值变化,术后清醒时间、拔管时间、ICU停留时间及术后住院时间,并对其做统计学分析。结果:在时间点T1、T2、T5上心率比较差异无统计学意义(P>0.05);在时间点T3、T4上观察组的平均心率分别为(64.4±11.7)次/min和(68.2±9.2)次/min,较对照组低,且差异有统计学意义(P<0.05)。在时间点T1、T2、T5上平均动脉压比较差异无统计学意义(P>0.05);在时间点T3、T4上观察组的平均动脉压分别为(76.9±11.5)mm Hg和(78.1±11.7)mm Hg,较对照组低,且差异有统计学意义(P<0.05)。与对照组比较,观察组拔管时间和ICU停留时间明显缩短,差异有统计学意义(P<0.05)。结论:麻醉诱导到维持过程中血流动力学的变化,丙泊酚联合舒芬太尼靶控输注较恒速泵注更加平稳,值得推广。

Objective：To observe the clinical effects of target-controlled infusion of Propofol combined with Sufentanil for maintain anesthesia in cardiac surgery.Method：46 cases underwent heart surgery from January 2010 to June 2012 were divided into the observation group（23 cases） and control group（23 cases）, by random number table.In the observation group,general anesthesia were induced and maintained by target-controlled infusion of Sufentanil and Propofol,in the control group,anaesthesia was managed with Propofol by a continuous infusion and Sufentanil intravenously after induction.Heart rate,mean arterial blood pressure values change at operating room（T1）,induced immediate（T2）,intubation （T3）,sternotomy（T4）,off the sternum（T5） were analysed.Result：About heart rates at T1,T2,T5,there were not statistically significant（P〉0.05）.Average heart rates at T3,T4 in the observation group were （64.4±11.7） bpm and 68.2±9.2）bpm,these were lower than those in the control group,there were statistically significant （P〈0.05）.About mean arterial pressure at T1,T2,T5,there were not statistically significant（P〉0.05）.Mean arterial blood pressure at T3,T4 in the observation group were （76.9±11.5）mm Hg and （78.1±11.7）mm Hg,these were lower than those in the control group,and there were statistically significant（P＆lt;0.05）.Compared with control group,observation group showed earlier tracheal decannulation,shorter ICU stay length（P＆lt;0.05）.Conclusion：Considering about the blood pressure and heart rate changes during anesthesia,Propofol combined with Sufentanil for target controlled infusion is more excellent in cardiac surgery,is worthy of application.