舒芬太尼与芬太尼麻醉对老年腹腔镜胆囊切除术患者血流动力学的影响

Research of sufentaniland fentanyl to blood flow dynamics in elderly laparoscopiccholecystectomy patients

目的探讨舒芬太尼与芬太尼麻醉对老年腹腔镜胆囊切除术患者血流动力学的影响。方法选取2010年9月至2013年9月本院行择期腹腔镜胆囊切除术的老年患者180例,按照麻醉用药不同将患者分为舒芬太尼组和芬太尼组,每组各90例。舒芬太尼组患者采用舒芬太尼联合咪达唑仑、丙泊酚和顺式阿曲库铵麻醉,芬太尼组患者采用芬太尼联合咪达唑仑、丙泊酚和顺式阿曲库铵麻醉。记录并比较两组患者在麻醉诱导各时间点的血压及心率(HR)等血流动力学指标的变化情况。结果麻醉诱导前(T0)两组患者的收缩压(SBP)、舒张压(DBP)、HR比较无显著性差异(P>0.05);麻醉诱导后(T1)两组患者SBP、DBP、HR较T0显著下降(P<0.05),舒芬太尼组下降幅度较小(P<0.05);插管时(T2)、拔管后(T3)两组患者SBP、DBP、HR较T0均有显著提高(P<0.05),舒芬太尼组上升幅度较小,差异显著(P<0.05)。结论较芬太尼而言,舒芬太尼应用于老年腹腔镜胆囊切除术对患者血流动力学影响更小,更适用于老年患者。

Objective To investigate theinfluence of sufentanil and fentanyl to blood flow dynamics in elderly laparoscopic cholecystectomy patients. Method From September 2010 to September 2013 in our hospital for elective laparoscopic cholecystectomy in elderly patients with 180 cases, according to the different anesthetic drugs were divided into sufentanil group and fentanyl group, 90 patients in each group. Sufentanil group with sufentanil combined with midazolam, propofol and cisatracurium anesthesia, fentanyl group with fentanyl combined with midazolam, propofol and cisatracurium anesthesia. Recorded and compared two groups of patients in blood pressure and heart rate at each time point during anesthesia induction （HR） changes in hemodynamic parameters. Result Before induction of anesthesia the SBP, DBP, HR had no significant differences between two groups （P〉0.05）;after induction of anesthesia （T1） the SBP, DBP, HR levels of both two groups decreased signiifcantly （P〈0.05）, and sufentanil group decreased less （P〈0.05）;after extubation （T3） the SBP, DBP, HR of both two groups were signiifcantly increased （P〈0.05） compared with T0, and sufentanil group increased less （P〈 0.05）. Conclusion Compared with fentanyl, sufentanil on elderly laparoscopic cholecystectomy surgery on hemodynamics in patients with smaller, more suitable for elderly patients.