【摘要】：目的探討舒芬太尼復(fù)合異丙酚麻醉在急性心肌梗死鎮(zhèn)痛中的應(yīng)用效果。方法按隨機(jī)數(shù)字表法將118例急性心肌梗死鎮(zhèn)痛患者分為舒芬太尼組與瑞芬太尼組,每組59例。舒芬太尼、瑞芬太尼初始靶效應(yīng)室濃度分別為0.25、2ng/ml,均復(fù)合初始血漿靶濃度為2μg/ml的異丙酚,每2min增加0.5μg/ml,直至患者意識消失。比較兩組患者在麻醉誘導(dǎo)前(T0)、插管前(T1)、插管后即刻(T2)、插管后2min(T3)、術(shù)畢(T4)和拔管(T5)時的血流動力學(xué)變化以及兩組麻醉情況、蘇醒時間、術(shù)后鎮(zhèn)痛效果、并發(fā)癥發(fā)生情況。結(jié)果兩組收縮壓(SBP)和舒張壓(DBP)于T0 T2時逐漸下降,T2 T5時逐漸上升,心率(HR)于T0 T1時逐漸下降,T1 T5時逐漸上升,但瑞芬太尼組波動較舒芬太尼組更為明顯。兩組SBP和DBP于T1 T5時有顯著性差異,HR于T1、T2和T5時有顯著性差異(P0.05)。兩組麻醉時間、意識消失時間、意識消失時異丙酚劑量和異丙酚總劑量無顯著性差異(P0.05);舒芬太尼組自主呼吸恢復(fù)時間、呼之睜眼時間、拔管時間和定向力恢復(fù)時間均明顯長于瑞芬太尼組(P0.05),VAS評分顯著高于瑞芬太尼組,鎮(zhèn)痛藥使用率及并發(fā)癥發(fā)生率明顯低于瑞芬太尼組(P0.05)。OAA/S評分兩組間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論與瑞芬太尼相比,舒芬太尼復(fù)合異丙酚麻醉用于急性心肌梗死鎮(zhèn)痛患者,血流動力學(xué)更加平穩(wěn),術(shù)后蘇醒質(zhì)量更優(yōu),并發(fā)癥更少,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the analgesic effect of sufentanil combined with propofol in acute myocardial infarction. Methods 118 patients with acute myocardial infarction were randomly divided into sufentanil group and remifentanil group with 59 cases in each group. Sufentanil and remifentanil were combined with propofol with initial plasma target concentration of 2 渭 g/ml, which were 0.25g / ml and 0.25g / ml, respectively, and increased by 0.5 渭 g / ml per 2min until the patient's consciousness disappeared. The hemodynamic changes before anesthesia induction (T0), before intubation (T1), immediately after intubation (T2), after intubation (T3), after operation (T4) and extubation (T5) were compared between the two groups. Postoperative analgesia and complications. Results systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased gradually at T _ 0 T _ 2, increased at T _ 2 T _ 5, decreased at T _ 0 T _ 1, and increased at T _ 1 / T _ 5, but the fluctuation was more obvious in remifentanil group than in sufentanil group. There was significant difference between SBP and DBP at T1 / T5 and HR at T1 / T5 (P0.05). There was no significant difference in anesthetic time and total dose of propofol between the two groups when consciousness disappeared (P0.05). The time of spontaneous respiratory recovery, eye opening, extubation and remifentanil group in sufentanil group was significantly longer than that in remifentanil group (P0.05), VAS score was significantly higher than that in remifentanil group. The incidence of analgesics and complications was significantly lower than that of remifentanil group (P0.05). There was no significant difference in OAA/S score between the two groups (P0.05). Conclusion compared with remifentanil, sufentanil combined with propofol anesthesia for acute myocardial infarction analgesia patients, hemodynamics is more stable, postoperative recovery quality is better, fewer complications, worthy of clinical application.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院急診科;
【分類號】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 甘麗霞;梁寧;;CO_2氣腹對老年患者呼吸循環(huán)功能影響的研究進(jìn)展[J];廣西醫(yī)學(xué);2010年07期

2 周仁龍;王珊娟;杭燕南;;雷米芬太尼靶控輸注在老年患者全麻誘導(dǎo)中的應(yīng)用[J];臨床麻醉學(xué)雜志;2008年02期

3 呂寶勝;王卓強(qiáng);王衛(wèi);解恩宇;房芳;張晨;;七氟烷或丙泊酚復(fù)合瑞芬太尼麻醉在重癥肌無力患者胸腺切除術(shù)中的應(yīng)用[J];解放軍醫(yī)學(xué)雜志;2013年07期

4 馬東星;劉惠亮;姚宏英;穆雷;吳曉霞;韓瑋;楊勝利;羅建平;;急診經(jīng)皮冠狀動脈介入治療術(shù)中冠狀動脈內(nèi)注射鹽酸替羅非班對急性ST段抬高型心肌梗死患者心肌灌注及心功能的影響[J];中國全科醫(yī)學(xué);2010年05期

5 周翔;王慶利;季蒙;陳利民;;異丙酚聯(lián)合瑞芬太尼靶控輸注與恒速輸注模式在顱腦外科手術(shù)中效果比較[J];實(shí)用醫(yī)學(xué)雜志;2009年08期

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 郭正綱;郝建華;賈曉鵬;祈U，

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