摘要
目的 探讨联合应用瑞芬太尼和舒芬太尼对肝癌切除术患者麻醉效果、应激反应及血流动力学的影响.方法 本研究为前瞻性研究,选取贵州省人民医院 2022 年 1 月至 2022 年 12 月期间的 82 例行肝癌切除术患者,采用随机数字表法将其分为研究组(瑞芬太尼联合舒芬太尼麻醉)和常规组(瑞芬太尼麻醉),每组各 41 例.比较两组患者的应激反应、镇痛效果和血流动力学指标.结果 相较于麻醉前 0 min(T1),两组肝癌切除术患者在插管后 1 min(T3)和拔管后 1 min(T4)的肾上腺素(E)和去甲肾上腺素(NE)水平升高,差异具有统计学意义(P＜0.05);在术后 12 h(T7)和术后 24 h(T8),两组患者E和NE水平均降低降低,差异具有统计学意义(P＜0.05);在T3、T4、术后 6 h(T6)、T7 和T8 时研究组的E和NE水平比常规组低,差异具有统计学意义(P＜0.05).研究组患者的躁动评分、视觉模拟量表(VAS)评分及镇静/警觉评分比常规组低,差异具有统计学意义(P＜0.05).相较于T1 时,在气管插管前即刻(T2)两组患者的心率(HR)和平均动脉压(MAP)水平降低,差异具有统计学意义(P＜0.05);且在T3、T4 和拔管后 5 min(T5),研究组的HR和MAP水平比常规组低,差异具有统计学意义(P＜0.05).结论 瑞芬太尼和舒芬太尼联合麻醉可以有效地稳定患者血流动力学,维持良好的麻醉效果,并减轻患者的术后疼痛、躁动及应激反应.
Abstract
Objective To explore the effect of combined application of remifentanil and sufentanil on the anesthesia effect,stress response,and hemodynamics of patients undergoing hepatectomy.Methods This study is a prospective study.82 patients undergoing hepatectomy in Guizhou Provincial People's Hospital from January 2022 to December 2022 were selected.They were divided into the research group(remifentanil combined with sufentanil anesthesia)and the conventional group(remifentanil anesthesia)by the random number table method,with 41 cases in each group.The stress response,analgesic effect,and hemodynamic indicators of the two groups of patients were compared.Results Compared with 0 min before anesthesia(T1),the levels of adrenaline(E)and norepinephrine(NE)in patients undergoing hepatectomy in both groups increased 1 min after intubation(T3)and 1 min after extubation(T4),and the differences were statistically significant(P＜0.05);at 12 h after surgery(T7)and 24 h after surgery(T8),the levels of E and NE in both groups decreased,and the differences were statistically significant(P＜0.05);at T3,T4,6 h after surgery(T6),T7,and T8,the levels of E and NE in the research group were lower than those in the conventional group,and the differences were statistically significant(P＜0.05).The agitation score,visual analogue scale(VAS)score,and sedation/alertness score of patients in the research group were lower than those in the conventional group,and the differences were statistically significant(P＜0.05).Compared with T1,the heart rate(HR)and mean arterial pressure(MAP)levels of patients in both groups decreased immediately before intubation(T2),and the differences were statistically significant(P＜0.05);and at T3,T4,and 5 min after extubation(T5),the HR and MAP levels of the research group were lower than those of the conventional group,and the differences were statistically significant(P＜0.05).Conclusion Remifentanil and sufentanil combined anesthesia can effectively stabilize the patient's hemodynamics,maintain a good anesthesia effect,and reduce the patient's postoperative pain,agitation,and stress response.
国家科技期刊平台
NSTL
万方数据