目的 比较舒芬太尼以及瑞芬太尼应用于老年腹腔镜胆囊切除术患者麻醉深度及应激反应的影响.方法 选择本院收治的90例老年腹腔镜胆囊切除患者,将其随机分为观察组以及对照组,每组45例,观察组采用舒芬太尼0.4μg/kg进行麻醉诱导,对照组使用瑞芬太尼2.0μg/kg进行麻醉诱导,比较两组患者的麻醉期间血压、心率水平变化以及术后应激反应情况.结果 两组患者在麻醉诱导后、插管后5 min、气腹后2 min、切皮时以及拔管时的SBP、DBP、HR比较均有明显差异,术中观察组的血压、心率变化较对照组平稳(P＜0.05);观察组于拔管即刻、拔管后30 min的VAS评分分别为(3.3±1.4)分以及(3.6±1.4)分,明显低于对照组的(7.6±1.5)分以及(7.2±1.7)分,观察组拔管即刻、拔管后30 min的躁动评分分别为(2.1±0.4)分以及(2.5±0.3)分,均显著低于对照组的(4.3±0.8)分以及(4.5±0.7)分,组间比较差异有统计学意义(P＜0.05).结论 舒芬太尼应用于老年腹腔镜胆囊切除术中能够维持一定的麻醉深度,使得围手术期的生命体征维持稳定,同时又能够降低术后应激反应,减轻患者痛苦,且并不延长苏醒时间,值得临床推广应用.%Objective To compare the effect of sufentanil and remifentanil on anesthetic depth and stress response in elderly patients with laparoscopic cholecystectomy.Methods 90 elderly patients with laparoscopic cholecystectomy in our hospital were randomly divided into observation group and control group,45 cases in each group.Observation group underwent anesthesia induction with sufentanil 0.4 ug/kg,while control group underwent anesthesia induction with remifentanil 2.0 ug/kg.Compared the changes of blood pressure,heart rate (HR) during anesthesia,and postoperative stress reactions between two groups.Results There were statistically significant differences in SBP,DBP,HR after anesthesia induction,5 minutes after intubation,2 minutes after pneumoperitoneum,when skin incision and when performing extubation between two groups (P＜0.05),the changes of blood pressure,HR were more smooth in observation group (P＜0.05).VAS score at the time of extubation,30 min after extubation in observation group were (3.3±1.4),(3.6±1.4),significantly lower than (7.6±1.5),(7.2±1.7) in control group;agitation score at the time of extubation,30 min after extubation in observation group were (2.1±0.4),(2.5±0.3),significantly lower than (4.3±0.8),(4.5±0.7) in control group,with statistically significant differences between two groups (P＜0.05).Conclusions Sufentanil used in elderly patients with laparoscopic cholecystectomy can maintain in certain depth of anesthesia,make perioperative period vital signs stable,reduce postoperative stress reactions,alleviate the suffering of patients,and does not extend the recovery time,worthy of clinical application.
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