摘要
目的研究比较舒芬太尼和芬太尼在体外循环(CPB)心脏瓣膜置换手术中对血流动力学及乳酸的影响。方法择期行瓣膜置换手术患者40例,随机分成两组,每组20例。舒芬太尼组(S组)分别于麻醉诱导、切皮前及转流前静注舒芬太尼1μg/kg、2μg/kg、2μg/kg;芬太尼组(F组)静注芬太尼10μg/kg、20μg/kg、20μg/kg。比较两组术中血流动力学参数及乳酸浓度。结果两组患者麻醉效果满意。S组于切皮和开胸两个时点HR、MAP、MPAP、SVR低于F组(P<0.05)。血乳酸浓度两组变化趋势相同。术前乳酸基础浓度S组与F组比较,差异无显著性(P>0.05),CPB开始后15和45 m in,复温至35℃和停机后30m in S组均低于F组(P<0.05)。结论体外循环瓣膜置换手术中使用舒芬太尼麻醉,可以使血流动力学更平稳,并可减轻全身应激反应,增加组织灌注,减少乳酸生成。
OBJECTIVE To compare the effects of sufentanil and fentanyl on hemodynamics and lactate levels in cardiac surgery with cardiopulmonary bypass （CPB）. METHODS Forty patients scheduled for valve replacement surgery were randomly divided into sufentanil group （S group） and fentanyl group （F group） ,20 cases in each group. At the time of anesthesia induction, pre -incision and pre - CPB, sufentanil 1 μg/kg, 2μg/kg and 2μg/kg was injected intravenously in S group; fentanyl 10μg/kg, 20μg/kg and 20μg/kg was gave in F group. Intraoperative hemodynamics and plasma lactate levels in the two groups were compared. RESULTS The anesthesia was well tolerated for the two groups. HR, MAP, MPAP and SVR in S group were significantly lower（ P 〈 0.05 ）than that in F group at incision and sternotomy. The elevated tendency of plasma lactate levels in two groups were similar. The baseline lactate levels in S group and F group were without statistic differences（ P 〉0.05）. At the time of 15 and 45 min during CPB, body temperature rewanned to 35℃ and 30min post - CPB, the elevation of lactate levels in S group were significantly lower than that in F group respectively（ P 〈0.05）. CONCLUSION The anaesthesia with sufentanil in valve replacement surgery can be safely performed with steady hemodynamics and light neurohormonal activation, and as a result, to increase the perfusion of the tissue and decrease the lactic product.
出处
《中国体外循环杂志》
2006年第1期26-29,共4页
Chinese Journal of Extracorporeal Circulation
