CAJ | 학술논문

目的：探讨合并心血管疾病患者的普外科手术麻醉中应用瑞芬太尼和舒芬太尼的效果。方法选择我院普外科收治合并有心血管疾病的手术患者100例，根据手术麻醉方法将其分为瑞芬太尼组50例及舒芬太尼组50例。对比两组气管拔管时间、术后清醒时间、镇痛效果，以及两组插管即刻、插管后1 min、插管后3 min时血压及心率的变化。结果舒芬太尼组气管拔管时间显著短于瑞芬太尼组（P＜0.05）；术后清醒时间显著长于瑞芬太尼组（P＜0.05）。两组VAS镇痛评分对比无明显差异（P＞0.05）。瑞芬太尼组插管后1 min时DBP、SBP、HR显著高于插管即刻，且高于同期间段舒芬太尼组（P＜0.05）。两组插管后3 min时DBP、SBP、HR对比无明显差异（P＞0.05）。结论针对合并心血管疾病的普外科手术患者，其麻醉中应用瑞芬太尼和舒芬太尼均有显著的镇痛效果；虽然舒芬太尼使患者的清醒时间延长，但对血压及心率影响更小，更适于心血管疾病患者麻醉诱导。
목적：탐토합병심혈관질병환자적보외과수술마취중응용서분태니화서분태니적효과。방법선택아원보외과수치합병유심혈관질병적수술환자100례，근거수술마취방법장기분위서분태니조50례급서분태니조50례。대비량조기관발관시간、술후청성시간、진통효과，이급량조삽관즉각、삽관후1 min、삽관후3 min시혈압급심솔적변화。결과서분태니조기관발관시간현저단우서분태니조（P＜0.05）；술후청성시간현저장우서분태니조（P＜0.05）。량조VAS진통평분대비무명현차이（P＞0.05）。서분태니조삽관후1 min시DBP、SBP、HR현저고우삽관즉각，차고우동기간단서분태니조（P＜0.05）。량조삽관후3 min시DBP、SBP、HR대비무명현차이（P＞0.05）。결론침대합병심혈관질병적보외과수술환자，기마취중응용서분태니화서분태니균유현저적진통효과；수연서분태니사환자적청성시간연장，단대혈압급심솔영향경소，경괄우심혈관질병환자마취유도。
Objective To study the application of remifentanil and sufentanil anesthesia in patients with cardiovascular disease department of general surgery operation effect. Methods 100 patients admitted to the Department of general surgery operation in our hospital with cardiovascular disease patients, according to the operation method of anesthesia will be divided into remifentanil group of 50 cases and 50 cases of sufentanil group. Comparing the two groups of tracheal extubation time, postoperative recovery time, analgesic effect, and the change of blood pressure and heart rate of two groups of intubation, 1min after intubation, 3min after intubation time. Results sufentanil group extubation time was significantly shorter in the remifentanil group (P<0.05);postoperative awake time was longer than that of remifentanil group (P<0.05). No signiifcant difference between the two groups of VAS pain scores compared (P>0.05). Remifentanil group 1min after intubation when DBP, SBP, HR were signiifcantly higher than that of intubation, and higher than the corresponding segment sufentanil group (P<0.05). The two group 3min after intubation when DBP, SBP, HR compared no signiifcant difference (P>0.05). Conclusion according to the Department of general surgery surgery patients with cardiovascular disease, the narcotic analgesic effect in the application of remifentanil and sufentanil significantly; while sufentanil prolongs patient recovery time, but less influence on blood pressure and heart rate, more suitable for induction of anesthesia in patients with cardiovascular disease.