Efficacy of sufentanil on agitation and hemodynamic status during recovery period from etomidate-based anesthesia induction
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摘要: 目的 观察舒芬太尼用于预防老年患者依托咪酯全麻苏醒期躁动及应激反应的临床效果和安全性。 方法 选择90例美国麻醉医师协会(ASA)Ⅰ~Ⅱ级全麻下胃癌根治手术患者,年龄60~75岁,随机分为3组,S组为舒芬太尼组,F组为芬太尼组,R为瑞芬太尼组。S组全麻诱导、维持均为舒芬太尼,F组全麻诱导、维持均为芬太尼,R组全麻诱导、维持均为瑞芬太尼。记录患者围麻醉期间血流动力学变化,术毕患者均入复苏室,观察2组患者术后全麻恢复期并记录3组手术气管导管拔管后(T1)、20 min (T2)及30 min (T3)的MAP、HR及SpO2变化,复苏室停留时间、术后相关并发症、苏醒期的Riker镇静躁动和VAS评分,拔出导管后30 min进行面部表情、肢体动作、活动、哭闹、可抚慰性(FLACC)评分。 结果 在麻醉诱导期和术中3组患者血液动力学均稳定。在麻醉恢复期,舒芬太尼组(S组)患者平均心率和动脉压与芬太尼组(F组)、瑞芬太尼组(R组)比较更为平稳;舒芬太尼组患者躁动发生率及Riker躁动镇静评分、FLACC评分明显低于芬太尼组和瑞芬太尼组,差异有统计学意义(P<0.05);患者苏醒时间、拔管时间3组差异无统计学意义(P>0.05)。 结论 舒芬太尼可使患者苏醒期血流动力学环境更加稳定,不影响患者术后拔管和苏醒时间,可有效预防依托咪酯麻醉恢复期躁动的发生率和减少应激反应。Abstract: Objective To observe the effect and safety of Sufentanil for prevention from agitation and stress reaction during recovery period from etomidate-based anesthesia in elderly patients undergoing radical gastrectomy. Methods Ninety ASA Ⅰ-Ⅱ patients undergoing radical gastrectomy under general anesthesia,aged 60 to 75 years,were enrolled in this study.The patients were randomly divided into three groups:Group S(maintained with Sufentanil),Group F(maintained with Fentanyl) and Group R(maintained with Remifentanil).The hemodynamic changes during the anesthesia in all groups were recorded.The MAP,HR and SpO2 were recorded at T1(extubation),T2(20 minutes after extubation) and T3(30 minutes after extubation).The stay in the recovery room,postoperative complications,Riker Sedation-Agitation score and VAS score in the recovery period,and FLACC score for facial expressions,body movements,activities,crying,can be soothing 30 minutes after the extubation were documented. Results During Induction of Anesthesia and surgery,the hemodynamics parameters in all three groups were stable.During recovery time,the heart rate and blood pressure in group S were more stable as compared with group F and group R;The incidence of agitation,Riker Sedation-Agitation score and FLACC score in the group S was obviously lower than those in group F and R,the difference was significant(P<0.05).The difference in the time to recovery and time to extubation among the three groups was not significant(P>0.05). Conclusion The maintain anesthesia with Sufentanil in patients undergoing radical gastrectomy can maintain a stable hemodynamics,not prolong the time to extubation and recovery,and effectively prevent the agitation caused by etomidate-based anesthesia during recovery period and decrease the stress reactions.
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Key words:
- Anesthesia /
- Sufentanil /
- Recovery time /
- Agitation
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