舒芬太尼靶控输注对心脏二尖瓣置换术后麻醉恢复的影响

Influence of anesthesia recovery quality for target controlled infusion of sufentanil in patients undergoing mitral valve replacement

目的 探讨舒芬太尼靶控输注（TCI）对心脏二尖瓣置换术后麻醉恢复的影响.方法 选取2011年10月～2013年10月在体外循环下实施二尖瓣置换术患者80例,通过随机数字表法将80例患者分为舒芬太尼组与芬太尼组各40例.对比舒芬太尼组与芬太尼组患者完成手术后选择血管活性药物进行治疗的效果.结果 在T1时,芬太尼组患者的MAP及HR明显低于舒芬太尼组（P＜0.05）,在T2～T4时,芬太尼组MAP及HR明显高于舒芬太尼组（P＜0.05）.舒芬太尼组患者在完成手术后的睁眼时间及拔管时间少于芬太尼组（P＜0.05）;术后出现呛咳、躁动及心动过速等症状的概率,舒芬太尼组少于芬太尼组（P＜0.05）.舒芬太尼组与芬太尼组完成拔管的48小时,对患者实施静态VAS评分,差异无显著性（P＞0.05）.在动态VAS评分方面,舒芬太尼组低于芬太尼组（P＜0.05）.在完成手术后,选择血管活性药物进行治疗的患者例数,舒芬太尼组少于芬太尼组（P＜0.05）.结论 针对患者实施心脏二尖瓣置换手术的过程中,选择舒芬太尼靶控输注,能够有效保证患者在手术过程中的血流动力学平稳.完成手术后,获得了较高的麻醉恢复质量.此外,在降低临床出现心血管不良事件概率以及完成手术后的镇痛效果方面,也具有显著意义.

Objective To evaluate the influence of the anesthesia recovery quality for target controlled infusion of sufentanil in patients undergoing mitral valve rcplacement（MVR）. Methods 80 ASA Ⅱ or Ⅲ patients undergoing MVR were divided into two groups sufentanilgroup and fentanyl group. The effect of vascular active drug treatment after the operation was observed. Results There were no significant difference in age, weight, sex and duration of operation between the two groups. On the T1, MAP and HR in fentanyl group were significantly lower than that of sufentanil group （P〈0.05）. On T2 - T4, MAP and HR in fentanyl group were significantly higher than that of sufentanil group （P〈0.05）. The awakening time and time for extubation in sufentanil group were significantly shorter than that of fenta- nyl group （P〈0.05）. The probability of symptoms such as choking cough, restlessness and tachycardia in sufentanil group were significantly less than that of fentanyl group （P〈0.05）. There was no significant difference in VAS scores of 48 hours post-anesthesia. The patients with vasoaetive medicines in sufentanil group were significantly less than fentanyl group （P〈0.05）. Conclusion Target controlled infusion of sufentanil for mitral valve replacemen can provide hemody- namie stability and high quality of anesthesia recovery.