瑞芬太尼与芬太尼在老年患者全身麻醉术中的应用效果及对其应激反应的影响比较分析

A Comparative Analysis of the Effects of Remifentanil and Fentanyl in Elderly Patients Undergoing General Anesthesia and Their Stress Responses

目的:比较分析瑞芬太尼与芬太尼在老年患者全身麻醉术中的应用效果及对其应激反应的影响。方法:选取2017年2月~2020年2月凉州区中西医结合医院收治的200例行全身麻醉手术的老年患者随机分为瑞芬太尼组和芬太尼组各100例,其中瑞芬太尼组予以瑞芬太尼麻醉,芬太尼组予以芬太尼麻醉。观察比较两组麻醉起效时间、拔管时间、自主呼吸恢复时间、睁眼时间及术后镇痛药物使用时间及血流动力学指标与应激反应指标变化情况和不良反应发生情况。结果:瑞芬太尼组麻醉起效时间、拔管时间、自主呼吸恢复时间、睁眼时间及术后镇痛药物使用时间均明显短于芬太尼组,差异有统计学意义(P<0.05)。瑞芬太尼组与芬太尼组T_(0)的MAP、HR、NE、E差异均无统计学意义(P>0.05),瑞芬太尼组T_(1)、T_(2)、T_(3)的MAP、HR、NE、E与T_(0)差异均无统计学意义(P>0.05),芬太尼组T_(1)、T_(2)、T_(3)的MAP、HR、NE、E均明显高于T_(0),差异有统计学意义(P<0.05),且均分别高于瑞芬太尼组T_(1)、T_(2)、T_(3)的MAP、HR、NE、E,差异有统计学意义(P<0.05)。瑞芬太尼组不良反应发生率4.00%,明显低于芬太尼组的10.00%,差异有统计学意义(P<0.05)。结论:相比于芬太尼,瑞芬太尼用于全身麻醉老年患者麻醉效果更佳,血流动力学更为稳定,应激反应小,不良反应发生率低。

Objective To compare and analyze the effects of remifentanil and fentanyl in elderly patients undergoing general anesthesia and their effects on stress response.Method 200 elderly patients who underwent general anesthesia in our hospital from February 2017 to February 2020 were selected as the research subjects,and were randomly divided into remifentanil group(n=100)and fentanyl group(n=100);Remifentanil group was remifentanil anesthesia,fentanyl group was given fentanyl anesthesia;observe and compare the anesthesia onset time,extubation time,spontaneous breath recovery time,eye opening time and postoperative Analgesic drug use time,changes in hemodynamic indexes and stress response indexes and occurrence of adverse reactions.Results The anesthetic onset time,extubation time,spontaneous breath recovery time,eye opening time,and postoperative analgesic drug use time in the remifentanil group were significantly shorter than those in the fentanyl group(P<0.05).There was no significant difference in MAP,HR,NE,E of T_(0)between remifentanil group and fentanyl group(P>0.05),there was no significant difference between MAP,HR,NE,ET,T_(2),T_(3)in remifentanil group and T_(0)(P>0.05),MAP,HR,NE,E of T_(1),T_(2),T_(3)in fentanyl group were significantly higher than T_(0)(P<0.05),and were higher than MAP,HR,NE,E of T_(1),T_(2)and T_(3)in remifentanil group,respectively(P<0.05).The incidence of adverse reactions in the remifentanil group was 4.00%,which was significantly lower than 10.00%in the fentanyl group(P<0.05).Conclusion Compared with fentanyl,remifentanil is more effective for general anesthesia in elderly patients with anesthesia,hemodynamics is more stable,stress response is small,and the incidence of adverse reactions is low.