舒芬太尼、瑞芬太尼在急诊脑外伤手术麻醉中的临床应用被引量：11

Application and Adverse Reactions of Sufentanil, Remifentanil in the Anesthesia of Brain Trauma Emergency Surgery

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摘要目的:探讨急诊脑外伤手术麻醉中舒芬太尼、瑞芬太尼的应用及其不良反应。方法:择取200例脑外伤患者随机分为研究组和对照组,手术前用多功能的监护仪实时监测相关血流动力学指标,麻醉诱导后,气管插管连接麻醉机行呼吸控制,研究组静脉泵注舒芬太尼,对照组静脉泵注瑞芬太尼,待病情稳定后,观察患者治疗后的血流动力学指标、手术情况、苏醒后恢复情况及不良反应。结果:1与对照组比较,治疗后的研究组患者除Sp O_2指标没有明显差异外,SBP、DBP、HR均明显高于对照组(P均<0.05);2研究组患者麻醉维持时间明显多于对照组,而自主呼吸时间、、睁眼时间及意识清醒时间明显少于对照组(P均<0.05);3研究组患者的手术时间、术后置管的时间、住院时间、住ICU时间、VAS评分均明显低于对照组(P均<0.05);4研究组患者不良反应发生率为3%,明显低于对照组(P<0.05)。结论:舒芬太尼在急诊脑外伤手术中的麻醉效果及不良反应发生率要明显好于瑞芬太尼,若患者没有禁忌、药物过敏反应,舒芬太尼为急诊脑外伤手术的首选麻醉药物。 Objective： To investigate the application and adverse reactions of sufentanil and remifentanil in the anesthesia of brain trauma emergency surgery. Methods： 200 patients of traumatic brain injury were randomly divided into research group and control group.Before surgery, the hemodynamics and other indicators of the patients were detected by RT multifunction monitor, after induction of anesthesia, the tracheal intubation connecting with anesthesia apparatus were performed to control patients＇ breathing. The patients in research group were treated with sufentanil intravenous infusion, and the patients in control group were treated with remifentanil intravenous infusion. The hemodynamic parameters, operation conditions, after waking recovery and adverse reactions were observed and compared between two groups. Results： 1Compared with the control group, the Sp O2 of the research group had no significant difference, the SBP, DBP and HR of the research group was all higher than that of control group.2 The maintain anesthesia time of research group was more than that of the control group, while the recovery time of spontaneous breathing, eye opening time and time conscious of research group was shorter than that of control group. 3The operative time, catheterization time, hospital stay, ICU stay, VAS scores were of research group were all less than those of control group.4 The adverse reaction rate of 3 %, significantly lower in research group than that of control group. Conclusions： Sufentanil anesthesia in emergency brain surgery and trauma was significantly superior to remifentanil with less adverse reactions, if the patient has no special drug allergies or contraindications, Sufentanil can be considered as the preferred anesthetic.