CAJ | 학술논문

目的：观察瑞芬太尼联合舒芬太尼TCI对老年患者围术期应激反应及术后疼痛的影响。方法选择60例ASAⅠ-Ⅱ级择期行腹部手术的全麻患者随机分为两组，A组和B组，每组各30例。观察并记录两组麻醉诱导前（T0）、插管前即刻（T1）、插管后1min（T2）、开腹后1min（T3）、及拔管后1min（T4）患者的收缩压（SBP）、舒张压（DBP）、心率（HR）。记录两组患者术中血压、心率剧烈波动时的调控次数、术后24h VAS评分及术后24h镇痛药用量。结果与T0时比较，两组患者T1时刻MAP（平均动脉压）明显下降，HR明显减慢（P＜0.05）。B组T2～T5时刻的MAP、HR变化情况相比较A组T2～T5时刻有显著差异性（P＜0.05），B组在术中血压、心率波动的调控次数、术后24h VAS评分及术后24h镇痛药用量均明显少于A组（P＜0.05）。结论瑞芬太尼联合舒芬太尼应用于老年患者的全麻手术，能有效减少围术期的应激反应，有利于血流动力学平稳，并且避免了瑞芬太尼导致的术后痛觉过敏现象发生。
목적：관찰서분태니연합서분태니TCI대노년환자위술기응격반응급술후동통적영향。방법선택60례ASAⅠ-Ⅱ급택기행복부수술적전마환자수궤분위량조，A조화B조，매조각30례。관찰병기록량조마취유도전（T0）、삽관전즉각（T1）、삽관후1min（T2）、개복후1min（T3）、급발관후1min（T4）환자적수축압（SBP）、서장압（DBP）、심솔（HR）。기록량조환자술중혈압、심솔극렬파동시적조공차수、술후24h VAS평분급술후24h진통약용량。결과여T0시비교，량조환자T1시각MAP（평균동맥압）명현하강，HR명현감만（P＜0.05）。B조T2～T5시각적MAP、HR변화정황상비교A조T2～T5시각유현저차이성（P＜0.05），B조재술중혈압、심솔파동적조공차수、술후24h VAS평분급술후24h진통약용량균명현소우A조（P＜0.05）。결론서분태니연합서분태니응용우노년환자적전마수술，능유효감소위술기적응격반응，유리우혈류동역학평은，병차피면료서분태니도치적술후통각과민현상발생。
Objective To observe the inlfuence of remifentanil combined with sufentanil TCI on perioperative stress reaction and postoperative pain in elderly patients.Method Choose general anesthesia were randomly divided into 60 cases of ASA gradeⅠ-Ⅱundergoing abdominal operation into two groups,A group and B group, 30 cases in each group. The two groups were observed and recorded before induction of anesthesia (T0), immediately before intubation (T1), 1min after intubation (T2), 1min after operation (T3), and 1min after extubation (T4) in patients with systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR). Recording control patients in the two groups of blood pressure, heart rate, lfuctuation of the number of 24h after operation VAS score and postoperative analgesic dosage of 24h. Results Compared with T0, T1 in the two groups were signiifcantly decreased at MAP, HR was signiifcantly decreased (P<0.05). MAP, HR B T2-T5 changes time compared to the A group of T2-T5 time has signiifcant difference (P<0.05), B group in intraoperative blood pressure, heart rate lfuctuations control times, postoperative 24h score of VAS and 24h postoperative analgesics were signiifcantly less than that in A group (P<0.05) Observation:Remifentanil and sufentanil in elderly patients with general anesthesia operation, can effectively reduce the stress response during perioperative period, is conducive to the stable hemodynamics, and avoid the phenomenon of remifentanil induced hyperalgesia after operation.