瑞芬太尼与舒芬太尼对老年腹腔镜直肠癌根治术患者围术期血流动力学影响的比较研究

A Comparative Study of the Effects of Remifentanil and Sufentanil on Perioperative Hemodynamics in Elderly Patients Undergoing Laparoscopic Radical Resection of Rectal Cancer

目的探讨瑞芬太尼和舒芬太尼对行腹腔镜直肠癌根治术的老年患者围术期f血流动力学的影响。方法选取2019年9月一2020年6月在北部战区总医院行直肠病根治术的老年患者40例,随机分为I组和II组.各20例。I组给予七氟烷联合瑞芬太尼麻醉,II组给予七氟烷联合舒芬太尼麻醉。观察比较两组围术期各时间点脑电双频指数.血压、心率,以及麻醉恢复期情况。结果两组气腹后血压和心率均升高,I组气腹后5minf血压高于II组,差异有统计学意义(P<0.05)。拔除气管导管后5 min两组血压和心率均较术前升高,而且I组血压和心率均较II组高,差异有统计学意义(P<0.05)。两组不同时间点脑电双频指数值差异均无统计学意义(P>0.05)。I组自主呼吸恢复时间与拔管时间均较I组长,差异有统计学意义(P<0.05)。两组气腹前后呼气末二氧化碳分压差异无统计学意义(P>0.05)。结论瑞芬太尼和舒芬太尼均能满足行腹腔镜直肠癌根治术老年患者的麻醉要求,而且舒芬太尼对患者围术期血流动力学的影响较小,更有利于老年患者术中麻醉的维持与术后恢复。

Objective To investigate the effects of remifentanil and sufentanil on perioperative hemodynamics in elderly patients undergoing laparoscopic radical resection of rectal cancer.Methods A total of 40 elderly patients undergoing laparoscopic radical resection of rectal cancer in General Hospital of Northem Theater Command from September of 2019 to June of 2020 were randomly divided into group Ⅰ and group 11 with 20 cases in each group.Group I was given sevoflurane combined with remifentanil anesthesia,group Ⅱ was given sevoflurane combined with sufentanil anesthesia.The bispectral index(BIS),blood pressure(BP),heart rate(HR)during the perioperative,and anesthesia recovery period were compared between the two groups.Results The BP and HR were increased in the two groups after pneumoperitoneum.The BP in group Ⅰ was significantly higher than group Ⅱ at 5 minutes after pneumoperitoneum(P<0.05).The BP and HR of the two groups were higher than those before operation at 5 minutes after extubation,and the BP and HR of group Ⅰ were significantly higher than that of group Ⅱ(P<0.05).There was no significant difference in BIS between the two groups at different time points(P>0.05).The recovery time of spontaneous breathing and extubation time in group Ⅱ were significantly longer than those in group I(P<0.05).There was no significant difference in end-tidal PaC02 between the two groups before and after pneumoperitoneum(P>0.05).Conclusion Remifentanil and sufentanil can meet the anesthesia requirements of elderly patients undergoing laparoscopic radical resection of rectal cancer,and sufentanil has less influence on perioperative hemodynamics,which is more conducive to the maintenance of anesthesia and postoperative recovery in elderly patients.