CAJ | 학술논문

目的探讨小剂量芬太尼用于心脏瓣膜置换术快通道麻醉的可行性及安全性.方法随机将40例瓣膜置换术患者分为两组,每组20例,组Ⅰ为快通道麻醉,组Ⅱ为大剂量芬太尼麻醉.观察两组不同时间段血压、心率、血氧饱和度、中心静脉压、体温、气道压变化,及术后拔管时间、监护室(ICU)停留时间、住院时间、肺部并发症,对各项观察值进行统计学分析.结果芬太尼用量(μg/kg):组Ⅰ(23.25±1.32)比组Ⅱ(35.75±6.84)少(P＜0.05);拔管时间、ICU停留时间、住院时间,组Ⅰ是(7.92±3.16)h、(25.12±7.50)h、(28.50±8.94)d,组Ⅱ是(13.70±5.63)h、(37.53±13.19)h、(38.00±12.90)d,组Ⅰ均较组Ⅱ短(P＜0.05);组Ⅱ有4例肺部感染,组Ⅰ无肺部感染(P＜0.05).结论小剂量芬太尼用于瓣膜置换术快通道麻醉安全可靠,可缩短术后拔管时间、ICU停留时间、住院时间,减少术后肺部并发症和住院费用.
목적 탐토소제량분태니용우심장판막치환술쾌통도마취적가행성급안전성.방법 수궤장40례판막치환술환자분위량조,매조20례,조Ⅰ위쾌통도마취,조Ⅱ위대제량분태니마취.관찰량조불동시간단혈압、심솔、혈양포화도、중심정맥압、체온、기도압변화,급술후발관시간、감호실(ICU)정류시간、주원시간、폐부병발증,대각항관찰치진행통계학분석.결과 분태니용량(μg/kg):조Ⅰ(23.25±1.32)비조Ⅱ(35.75±6.84)소(P＜0.05);발관시간、ICU정류시간、주원시간,조Ⅰ시(7.92±3.16)h、(25.12±7.50)h、(28.50±8.94)d,조Ⅱ시(13.70±5.63)h、(37.53±13.19)h、(38.00±12.90)d,조Ⅰ균교조Ⅱ단(P＜0.05);조Ⅱ유4례폐부감염,조Ⅰ무폐부감염(P＜0.05).결론 소제량분태니용우판막치환술쾌통도마취안전가고,가축단술후발관시간、ICU정류시간、주원시간,감소술후폐부병발증화주원비용.
Objective To investigate the feasibility and safety*with the low dose fentanyl for valve replacement fast track cardiac anesthesia. Methods 40 cases with cardiac valve replacement were divided into two groups,group Ⅰ :20 cases with fast track anesthesia,group Ⅱ :20 cases with large dose fentanyl anesthesia. The blood presure, HR, SpO2, CVP,Temperature, airway pressure were observed at different time points. The postoperative extubation time,ICU stay,hospital stay,postoperative pulmonary complications were recorded. Results The fentanyl(μg/kg) of group Ⅰ (23. 25 ± 1.32) was less than that of group Ⅱ ( 35.75 ± 6. 84) ( P < 0. 05 ); Extubation time (hours), ICU stay ( hours),length of stay (days) were ( 7.92 ± 3. 16), (25. 12 ± 7.50), ( 28.50 ± 8. 94 ) in group Ⅰ , and that were (13.70±5.63) ,(37.53 ±13. 19) ,(38.00 ± 12. 90) in group Ⅱ. The group Ⅰ were shorter than the group Ⅱ ,P<0. 05; There were four cases of lung infection in group Ⅱ, no one in group Ⅰ ( P < 0. 05 ); There were significant differences between the two groups. There were no significant differences in the remaining observations. Conclusion The low dose fentanyl anesthesia for fast track anesthesia in heart valve replacement surgery was reliable and safe;It could help to reduce postoperative extubation time, ICU stay time and hospital stay time and reduce postoperative pulmonary complications and hospital costs.