舒芬太尼诱导麻醉老年特重烧伤削切痂手术的临床观察

目的探讨老年人特重烧伤削切痂麻醉时使用舒芬太尼诱导瑞芬太尼维持辅助镇痛效果。方法老年人特重度烧伤手术患者75例,随机分为舒芬太尼诱导瑞芬太尼维持组(SR组),芬太尼诱导瑞芬太尼维持组(FR组),单纯瑞芬太尼组(RR组),每组25例。观察诱导前(T0)、诱导插管时(T1)、插管后1 min(T2)、插管后5 min(T3)、切痂1 min(T4),取皮1 min(T5)、平均动脉压(MAP)、心率(HR)值、记录术中体动、知晓情况、麻醉苏醒质量及术后4 h视觉模拟量表评分(VAS),静脉患者自控镇痛(PCIA)药物用量及术后并发症发生情况。结果麻醉期间血流动力学稳定SR组优于FR、RR组(P<0.01或P<0.05),术后4 h VAS评分及PCIA药物用量,SR组低于FR、RR组,FR组低于RR组(P<0.01);术后躁动SR组低于FR、RR组(P<0.01),FR组与RR组无差异;SR、RR组两组睁眼时间和拔管时间明显短于FR组(P<0.01),SR组与RR组无差异。结论接受舒芬太尼诱导麻醉的老年特重度烧伤患者,其术中血流动力学比较稳定,苏醒快速,不良反应少。

Sufentanil induced anethesia in the elderly with severe burn for surgical excision cutting

Objective To explore the efficacy of sufentanil induced anesthesia in severe burn patients cutting of old crust to maintain auxiliary of remifentanil analgesia.Methods 75 elderly patients with severe burn surgery were randomly divided into remifentanil sufentanil induction of the maintenance group(SR group),fentanyl,remifentanil induced by the maintenance group(FR group),remifentanil Group(RR group).Each group includes 25 patients.Observation was done before induction(T_0),during induction and intubation(T_...