【摘要】 目的探究舒芬太尼联合瑞芬太尼在老年腹部全麻手术中的麻醉效果。方法将2015年1月~2017年1月在我院行全麻下腹部手术治疗的105例老年患者随机分为3组,各35例;在手术中,A组患者仅予舒芬太尼药物镇痛,B组患者仅予瑞芬太尼药物镇痛,C组患者则予舒芬太尼和瑞芬太尼联合镇痛,比较3组患者麻醉前、插管后和拔管后的收缩压、舒张压、心率情况以及术后3、12、24h的VAS评分和苏醒期躁动情况评分。结果三组患者麻醉前收缩压、舒张压及心率比较差异无统计学意义(P>0.05);与麻醉前比较,A组和B组患者插管后、拔管后的收缩压、舒张压及心率均明显升高(P<0.05),而C组患者插管后、拔管后的收缩压、舒张压及心率变化不大(P>0.05);A、B组患者插管后、拔管后的收缩压、舒张压及心率均明显高于C组(P<0.05)。与C组比较,A组和B组患者术后3、12、24h的VAS评分均较高(P<0.05),而且A组和B组患者术后苏醒期躁动评分亦较高(P<0.05)。结论舒芬太尼联合瑞芬太尼应用于老年腹部手术中具有显著的镇痛效果,并且有效控制患者血流动力学稳定,减轻麻醉苏醒期躁动情况。更多还原

【Abstract】 Objective To explore the anesthesia effect of sufentanil combined with remifentanil in abdominal general anesthesia in elderly patients. Methods 105 elderly patients underwent abdominal surgery under general anesthesia in our hospital from January 2015 to January 2017 were randomly divided into three groups with 35 cases in each. In the operation, the patients in group A received only sufentanil analgesia, and the patients in group B received only remifentanil analgesia, while the patients in group C received sufentanil and remifentanil for analgesia. The systolic pressure, diastolic pressure and heart rate after anesthesia, after intubation and after extubation and the scores of 3, 12, 24 h and recovery agitation in VAS after operation of the three groups were compared. Results There was no significant difference in the systolic blood pressure, diastolic blood pressure and heart rate before and after anesthesia(P > 0.05) between the three groups. Compared with before anesthesia, the systolic blood pressure, diastolic blood pressure and heart rate of patients in group A and group B were significantly increased after intubation and extubation(P < 0.05), and the systolic pressure, diastolic blood pressure and heart rate after intubation and extubation in group C were not changed significantly(P > 0.05). The systolic blood pressure, diastolic blood pressure and heart rate after intubation and extubation in A and B groups were significantly higher than those in group C(P < 0.05). Compared with group C, the scores of 3h, postoperative 12 h and postoperative 24 h of A group and B group were higher(P < 0.05), and the scores of agitation in A and B groups were higher(P < 0.05) than those in group VAS. Conclusion Sufentanil combined with remifentanil in the elderly abdominal surgery has significant analgesic effect. And it can effectively control the hemodynamic stability of patients, and reduce the restlessness during the anesthesia recovery period.更多还原