张恩义　董金亮

【摘要】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。

【关键词】心血管疾病；普外科；手术麻醉；瑞芬太尼；舒芬太尼

【中图分类号】R54 【文献标识码】A

Analysis and Discussion on Application of remifentanil and sufentanil anesthesia in patients with cardiovascular disease department of general surgery surgery effect

ZHANG En-yi， DONG Jin-liang

（Helong city of traditional chinese medicine in jilin prorince， jilin Helong 133500， China）

【Abstract】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 significant difference between the two groups of VAS pain scores compared （P>0.05）. Remifentanil group 1min after intubation when DBP， SBP， HR were significantly 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 significant 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.

【Key words】Cardiovascular disease department of general surgery； Operation； Anesthesia； Remifentanil； Sufentanil

多数心血管疾病患者在普外科手术治疗时会出现血压升高、急性心梗、心律失常、充血性心力衰竭等不良事件，这对手术效果造成了严重的影响[1-2]。为探讨瑞芬太尼与舒芬太尼在普外科手术麻醉中对心血管疾病患者的作用，选择我院普外科收治的100例分别采用瑞芬太尼和舒芬太尼麻醉且合并心血管疾病的手术患者，对其病例资料给予回顾性分析，对比两种麻醉方法在临床中的应用效果，现报道如下。

1 资料与方法

1.1 临床资料

选择2012年1月～2014年1月期间我院普外科收治合并有心血管疾病的手术患者100例，其中男54例，女46例；……