舒芬太尼靶控输注在二尖瓣置换术中的应用效果

Effect of target controlled infusion of sufentanil on patients undergoing mitral valve replacement

目的:探讨舒芬太尼靶控输注(TCI)在二尖瓣置换术中的应用效果。方法:抽取2019年2月至2020年3月于郑州大学第二附属医院行心脏二尖瓣置换术的心脏病患者78例,按照随机数字表法分为芬太尼组和舒芬太尼组,每组39例。芬太尼组术中应用芬太尼进行麻醉,舒芬太尼组术中应用舒芬太尼TCI进行麻醉。观察比较两组围术期血流动力学指标、术后拔管和苏醒时间、视觉模拟评分法(VAS)评分及不良反应发生情况。结果:诱导10 min后,舒芬太尼组心率、平均动脉压高于芬太尼组(P<0.05);插管后、切皮时、劈胸骨时,舒芬太尼组心率、平均动脉压低于芬太尼组(P<0.05)。舒芬太尼组拔管时间及苏醒时间短于芬太尼组(P<0.05)。拔管时及拔管后4、24、48 h,舒芬太尼组VAS评分均低于芬太尼组(P均<0.05)。舒芬太尼组术后高血压、躁动、呕吐及心动过速等不良反应发生率低于芬太尼组(P<0.05)。结论:舒芬太尼TCI可有效稳定心脏二尖瓣置换术中患者的心率、血压等水平,相对于芬太尼,术后麻醉恢复时间更快,疼痛程度更低,且无严重不良反应发生,安全性更高。

Objective To investigate the effects of target-controlled infusion(TCI)of sufentanil on patients undergoing mitral valve replacement.Methods A total of 78 patients with heart disease who underwent mitral valve replacement in the Second Affiliated Hospital of Zhengzhou University from February 2019 to March 2020 were selected and divided into fentanyl group and sufentanil group according to the random number table method,with 39 cases in each group.Patients in fentanyl group were anesthetized with fentanyl during operation,and patients in sufentanil group were anesthetized with sufentanil TCI during operation.Perioperative hemodynamics indexes,postoperative extubation time,recovery time,visual analogue scale(VAS)score and adverse reactions were observed and compared between the two groups.Results After 10 min induction,the heart rate and mean arterial pressure of sufentanyl group were higher than those of fentanyl group(P<0.05).After intubation,during skin resection and during thoracotomy,the heart rate and average arterial pressure of sufentanil group were lower than those of fentanyl group(P<0.05).The postoperative extubation time and recovery time of sufentanil group were shorter than those of fentanyl group(P<0.05).At extubation,and 4 h,24 h and 48 h after extubation,the VAS scores of sufentanil group were lower than those of fentanyl group(all P<0.05).The incidence of adverse reactions such as hypertension,restlessness,vomiting and tachycardia in sufentanil group were lower than those in fentanyl group(P<0.05).Conclusions Sufentanil TCI can effectively stabilize heart rate,blood pressure and other levels in patients undergoing mitral valve replacement.Its advantages include faster postoperative recovery time from anesthesia,significant reduction in pain degree,no significant adverse reactions,and higher safety.