舒芬太尼和芬太尼对老年腹腔镜胆囊血流动力学的影响

Effect of Sufentanil and Fentanyl on the Hemodynamics of Laparoscopic Gallbladder in Elderly Patients

目的 分析舒芬太尼和芬太尼对老年腹腔镜胆囊血流动力学的影响。方法 回顾性选取2021年5月—2023年2月邳州市中医院收治的80例老年腹腔镜胆囊切术患者的临床资料,以随机数表法分为两组,每组40例,对照组实施芬太尼麻醉诱导与维持,观察组实施舒芬太尼麻醉诱导与维持,比较组间血流动力学指标、脑氧代谢指标及不良反应。结果 与T0时相比,T1时心率、收缩压、舒张压均降低,且观察组高于对照组,差异有统计学意义(P<0.05);T2时心率、收缩压、舒张压均有升高,且观察组低于对照组,差异有统计学意义(P<0.05);TI、T2时颈内静脉球部血氧饱和度升高,且观察组低于对照组,差异有统计学意义(P<0.05);T1、T2、T3时桡动脉-颈内静脉血样差值、脑氧摄取率均降低,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组不良反应率为0,较对照组的15.00%更低,差异有统计学意义(χ^(2)=4.505,P<0.05)。结论 针对老年腹腔镜胆囊切除术麻醉诱导与维持,舒芬太尼与芬太尼均会对患者的血流动力学指标造成一定的影响,但舒芬太尼维持下,患者的血流动力学更加稳定,同时还可减少不良反应。

Objective To analyze the effects of sufentanil and fentanyl on the hemodynamics of laparoscopic gallbladder in elderly patients.Methods The clinical data of eighty elderly patients undergoing laparoscopic cholecystectomy in Pizhou Hospital of Traditional Chinese Medicine from May 2021 to February 2023 were retrospectively selected and divided into two groups by random number table method,with forty cases in each group.The control group received fentanyl anesthesia induction and maintenance,and the observation group received sufentanil anesthesia induction and maintenance.Hemodynamic indexes,cerebral oxygen metabolism indexes and adverse reactions were compared between groups.Results Compared with T0,the heart rate,systolic blood pressure and diastolic blood pressure at T1 were decreased,and the observation group was higher than the control group,and the difference was statistically significant(P<0.05).At T2,the heart rate,systolic blood pressure and diastolic blood pressure were increased,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).The blood oxygen saturation of internal jugular vein bulbar increased at TI and T2,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).At T1,T2 and T3,the difference of blood samples from radial artery to internal jugular vein and the cerebral oxygen uptake rate were decreased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The adverse reaction rate of observation group was 0%,which was lower than that of control group(15.00%),and the difference was statistically significant(χ^(2)=4.505,P<0.05).Conclusion For the anesthesia induction and maintenance of laparoscopic cholecystectomy in elderly patients,both sufentanil and fentanyl can have a certain impact on the hemodynamic indexes of patients.However,under the maintenance of sufentanil,the hemodynamic indexes of patients are more stable,and adverse reactions can be reduced at the same time.