舒芬太尼持续输注用于胃癌根治术的临床观察

目的:观察舒芬太尼复合异丙酚持续输注用于胃癌根治术中的麻醉效果,并观察是否出现临床不良反应及麻醉并发症。方法:行胃癌根治术的患者220例,ASAI^II级,随机分成两组,S组(舒芬太尼复合异丙酚)110例,F组(芬太尼复合异丙酚)110例,术中S组持续输注舒芬太尼,F组持续输注芬太尼,记录麻醉诱导前(T0)、气管插管后即刻(T1)、切皮时(T2)、拔除气管导管即刻(T3)和拔除气管导管后5 min(T4)的MAP和HR,记录术后恢复阶段自主呼吸恢复时间、睁眼时间、拔管时间及拔管后5min病人的警觉/镇静评分(OAA/S评分)结果结果:F组在T1、T2、T3、T4时的MAP和HR均高于S组(P<0.05),与S组比较,F组自主呼吸恢复时间、轻唤睁眼时间、拔管时间延长,但差异无统计学意义(P>0.05),拔管后5 min OAA/S评分值低(P<0.05),两组间术中、术后临床不良反应及并发症发生情况比较差异无统计学意义(P>0.05)结结结论:论:论:舒芬太尼持续输注用于胃癌根治术中血流动力学稳定,术后苏醒质量高,不增加麻醉不良反应的发生率,麻醉可控性好,具有很好的临床应用价值。

Objective: to observe the anesthesia effect of continuous infusion of sufentanil combined with propofol in radical operation for gastric cancer, and observe whether there are adverse clinical reaction and anesthesia complications. Method: 220 patients(Grade ASAI^II) who experienced radical operation for gastric cancer were divided into two groups at random. S group(sufentanil combined with propofol) included 1100 patients, and F group(fentanyl) combined with propofol) included 1100 patients. In the operation, sufentanil was continuously infused for S group, while fentanyl was continuously infused for F group. MAP and HR were recorded before anesthesia induction(T0), immediately after trachea cannula(T1), during skin incision(T2), immediately after endotracheal tube was removed(T3) and after 5 min when endotracheal tube was removed(T3). Besides, in the stage of post-operative recovery, autonomous respiration recovery time, the time when the patients opened their eyes, tube removal time and patients' alertness/sedation score(OAA/S score) after 5 min when the tuve was removed were recorded. Results: MAP and HR of F group are higher than S group at T1, T2, T3 and T4(P<0.05). Compared with S group, autonomous respiration time, the time when the patients opened their eyes, tube removal time in F group extend, but the difference has no statistical significance(P>0.05); OAA/S score is low after 5min when the tube was removed(P<0.05). The comparison difference of intranperative and postoperative clinical reaction and omplications has no statistical significance(P>0.05). Conclusions: when continuous infusion of sufentanil is adopted in radical operation for gastric cancer, patients' haemodynamics is stable, and postoperative revival quality is high. In addition, the occurrence rate of adverse anesthesia reaction will not increase. Anesthesia controllability is good, too. Hence, sufentanil owns excellent clinical application value.