舒芬太尼对冠状动脉旁路移植术非体外循环麻醉的影响

Effects of sufentanil on off-pump coronary artery bypass

目的观察不同剂量舒芬太尼对冠状动脉旁路移植术非体外循环(OPCAB)麻醉的影响。方法选取115例行OPCAB手术治疗的患者,按照随机数字表法分为两组,每组57例。常规组予以常规剂量舒芬太尼辅助OPCAB手术,试验组予以低剂量舒芬太尼辅助OPCAB手术,比较两组围手术期体征变化情况,麻醉镇痛、镇静效果,苏醒情况,苏醒后麻醉相关不良反应发生情况。结果在不同麻醉方案下,试验组T0、T2时患者的心率(HR)、平均动脉压(MAP),苏醒后VAS、RASS的评分,术中知晓率与常规组比较均无统计学差异(P>0.05);试验组T1、T3时的HR、MAP均高于常规组,苏醒时间、CSICU停留时间均短于常规组(P<0.05);两组的麻醉相关不良反应发生率比较具有统计学差异(P<0.05)。结论低剂量舒芬太尼辅助OPCAB麻醉能有效维持患者围手术期基础体征稳定,镇痛、镇静效果好,安全性高。

Objective To observe the effects of different doses of sufentanil on off-pump coronary artery bypass(OPCAB).Methods 115 patients who underwent OPCAB surgery were divided into two groups using a number table method,with 57 patients in each group.The conventional group were received conventional dose sufentanil as an adjuvant for OPCAB surgery,while the experimental group were received low dose sufentanil as an adjuvant for OPCAB surgery.The changes in perioperative physical signs,anesthesia analgesia,sedation effects,awakening status,and occurrence of anesthesia related adverse reactions after awakening were compared between the two groups patients.Results Under different anesthesia regimens,there were no statistically significant differences between the experimental group and the conventional group in terms of heart rate(HR),mean arterial pressure(MAP)at T0 and T2,VAS and RASS scores after awakening,and intraoperative awareness rate(P>0.05);the HR and MAP of the experimental group at T1 and T3 were higher than those of the conventional group,while the awakening time and CSICU stay time in experimental group were lower than those of the conventional group(P<0.05);the difference in the incidence of anesthesia related adverse reactions between the two groups was statistically significant(P<0.05).Conclusion Low dose sufentanil assisted OPCAB anesthesia can effectively maintain the stability of patients′basic signs during the perioperative period,with good analgesic and sedative effects,low risk of adverse reactions,and high safety.