高原地区老年患者手术麻醉中芬太尼与瑞芬太尼静脉麻醉的应用探讨

Comparative Analysis of the Effect of Intravenous Anesthesia between Remifentanil and Fentanyl in Elderly Patients in at High Altitude Area

目的探讨高原地区老年患者手术麻醉中芬太尼与瑞芬太尼静脉麻醉的应用效果及其不良反应。方法选取我院自2010年1月—2012年10月收治的142例进行手术的老年患者进行分析研究,随机分为2组,每组71例,观察组患者采用瑞芬太尼进行麻醉,对照组患者采用芬太尼进行麻醉,观察两组患者的麻醉结果以及不良反应。结果观察组患者插管后收缩压为(113.2±15.1),舒张压为(77.2±10.6),术中收缩压为(121.3±10.3),舒张压为(79.6±10.5);对照组患者插管后收缩压为(135.1±16.9),舒张压为(89.3±14.6),术中收缩压为(136.2±20.5),舒张压为(88.7±12.6)。两组患者在插管后、术中血压、心率等较麻醉前有明显差异,P<0.05,具有统计学意义。观察组患者不良反应发生率为5.63%,对照组患者不良反应发生率为21.13%,差异具有统计学意义,P<0.05。结论芬太尼和瑞芬太尼都能应用于老年患者手术麻醉,但相对而言,瑞芬太尼的麻醉效果更好,不良反应更小,安全、有效,值得临床推广应用。

Objective To analyze the application effect of fentanyl and remifentanil intravenous anesthesia in elderly patients at high altitude area. Methods Chosen 142 cases patients in our hospital from Feb.2010 to Oct.2012, and divided into observation group and control group. The observation group was given remifentanil anesthesia, and the control group was given fentanyl anesthesia. The anesthetic effects of the 2 groups were compared. Results There was significant differences in SBP and DBP of 2groups increased after intubation（P〈0.05）,and the incidences of adverse effect showed significant difference between the observation（5.63 %）and the control（21.13%）groups（P〈0.05）. Conclusion Both the fentanyl and the remifentanil intravenous anesthesia in elderly patients work well, but remifentanil intravenous anesthesia has higher safety, shorter recovery time and more significant effects, which is worthy of clinical application.