舒芬太尼联合瑞芬太尼于胃癌根治术中的麻醉效果及对应激反应的影响被引量：1

Anesthetic Effect of Sufentanil Combined with Remifentanil during Radical Gastrectomy for Gastric Cancer and Its Impact on Stress Response

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摘要目的探讨在胃癌根治术中予舒芬太尼联合瑞芬太尼麻醉的效果及对应激反应的影响。方法选择2018年1月—2022年4月仪征市人民医院收治的胃癌根治术患者80例,随机分为对照组(n=40,采用瑞芬太尼麻醉)与观察组(n=40,联合舒芬太尼麻醉),比较两组镇静、镇痛效果,检测术前、插管后1 min、拔管后1 min患者的平均动脉压、心率,并检测术前、术后肾上腺素(E)、去甲肾上腺素(NE)水平。结果观察组躁动评分、警觉/镇静评分、术后6 h与12 h的VAS评分分别为(0.54±0.18)分、(3.75±0.83)分、(2.37±0.65)分、(3.02±1.03)分,均小于对照组,差异有统计学意义(t=11.247、4.250、8.500、6.476,P<0.05)。插管后1 min、拔管后1 min观察组平均动脉压分别为(86.42±8.76)mmHg、(88.40±8.52)mmHg、心率分别为(83.15±9.02)次/min、(83.40±8.75)次/min,均小于对照组,差异有统计学意义(t=4.586、4.055、4.721、5.605,P<0.05)。术后观察组E、NE水平分别为(268.92±38.53)pg/mL、(369.57±54.83)pg/mL,均低于对照组,差异有统计学意义(t=4.047、2.854,P<0.05)。结论对胃癌根治术者予舒芬太尼联合瑞芬太尼麻醉镇静镇痛效果可靠,患者术中血流动力学指标稳定,且可减轻机体应激反应。 Objective To explore the effect of anesthesia with sufentanil combined with remifentanil and the effect on stress reaction during radical operation for carcinoma of stomach.Methods Eighty cases of gastric cancer treated in Yizhong People's Hospital from January 2018 to April 2022 were selected as the study objects,and were randomly divided into control group(n=40,under remifentanil anesthesia)and observation group(n=40,combined with sufentanil anesthesia).The sedative and analgesic effects of the two groups were compared.Mean arterial pressure and heart rate were measured before surgery,1 min after intubation and 1 min after extubation,and epinephrine(E)and norepinephrine(NE)levels were measured before and after surgery.Results Agitation score,alertness/sedation score,VAS score 6 h and 12 h after operation were(0.54±0.18)points,(3.75±0.83)points,(2.37±0.65)points,(3.02±1.03)points,respectively,in the observation group,which were all lower than those in the control group,the difference was statistically significant(t=11.247,4.250,8.500,6.476,P<0.05).1 min after intubation and 1 min after extubation,the mean arterial pressure of the observation group was(86.42±8.76)mmHg,(88.40±8.52)mmHg,and the heart rate was(83.15±9.02)times/min and(83.40±8.75)times/min,respectively,which were lower than those of the control group,the difference was statistically significant(t=4.586,4.055,4.721,5.605,P<0.05).The E and NE levels in the observation group were(268.92±38.53)pg/mL and(369.57±54.83)pg/mL,respectively,which were lower than those in the control group,and the difference was statistically significant(t=4.047,2.854,P<0.05).Conclusion The sedative and analgesic effect of sufentanil combined with remifentanil in radical operation for carcinoma of stomach is reliable,and the patients'intraoperative hemodynamic indexes are stable and the stress response of the body can be reduced.

作者赵燕任晓梅何颖廉慧亭张玉清 ZHAO Yan;REN Xiaomei;HE Ying;LIAN Huiting;ZHANG Yuqing(Department of Anesthesiology,Yizheng People's Hospital,Yizheng,Jiangsu Province,211400 China)

机构地区仪征市人民医院麻醉科

出处《中外医疗》 2023年第4期157-160,共4页 China & Foreign Medical Treatment

基金 2020年度省第五期“333工程”科研项目资助计划项目(BRA2020179)。

关键词胃癌根治术舒芬太尼瑞芬太尼镇静血流动力学应激反应 Radical operation for carcinoma of stomach Sufentanil Remifentanil Sedation Hemodynamics Stress response

分类号 R735.2 [医药卫生—肿瘤] R614 [医药卫生—麻醉学]

作者简介赵燕(1978-),女,本科,副主任医师,研究方向为临床麻醉、胃癌根治术。