Comparison of Fentanyl, Sufentanil, and Alfentanil Anesthesia in Patients Undergoing Valvular Heart Surgery
Comparison of Fentanyl, Sufentanil, and Alfentanil Anesthesia in Patients Undergoing Valvular Heart Surgery
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芬太尼、舒芬太尼和阿芬太尼在心脏瓣膜手术患者麻醉中的比较
DOI：
10.1213/00000539-198412000-00006
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发表时间：
1984
影响因子：
5.7
通讯作者：
M. H. Hoeneveld
中科院分区：
文献类型：
--
作者：
J. Bovill;P. Warren;J. Schuller;H. V. van Wezel;M. H. Hoeneveld
研究了三组20例瓣膜置换术患者对麻醉和手术的血流动力学反应。麻醉分别由芬太尼（75 μg/kg）、舒芬太尼（15 μg/kg）或阿芬太尼（125 μg/kg）诱导。给予泮库溴铵（8 mg）用于肌肉松弛，肺供氧/空气通气（Flo2 = 0.5）。皮肤切开前给予芬太尼（25 μg/kg）或舒芬太尼（5 μg/kg）。接受阿芬太尼治疗的患者以0.5 mg·kg-1·hr-1的速率持续输注。只有平均动脉血压（MABP）和全身血管阻力（SVR）在麻醉或手术后发生显著变化。二尖瓣病变患者舒芬太尼诱导麻醉后MABP平均下降24.5 mm Hg （P < 0.01）。主动脉瓣病变患者服用芬太尼后，MABP和SVR显著升高（P < 0.01）。组内没有其他统计学上显著的变化。4例患者（舒芬太尼组2例，其他组各1例）在麻醉诱导过程中出现短暂性低血压。结论：三种阿片类药物均可为瓣膜置换术患者提供满意的麻醉效果。
The hemodynamic responses to anesthesia and surgery were studied in three groups of 20 patients undergoing valve replacement surgery. Anesthesia was induced with either fentanyl (75 μg/kg), sufentanil (15 μg/kg), or alfentanil (125 μg/kg). Pancuronium (8 mg) was given for muscle relaxation and the lungs were ventilated with oxygen/air (Flo2 = 0.5). Additional fentanyl (25 μg/kg) or sufentanil (5 μg/kg) was given before skin incision. Patients receiving alfentanil were given a continuous infusion at a rate of 0.5 mg·kg-1·hr-1. Only mean arterial blood pressure (MABP) and systemic vascular resistance (SVR) changed significantly in response to anesthesia or surgery. MABP decreased on average 24.5 mm Hg (P < 0.01) after induction of anesthesia with sufentanil in patients with mitral valve disease. MABP and SVR increased significantly (P < 0.01) in patients with aortic valve disease receiving fentanyl. There were no other statistically significant changes within the groups. Four patients (two in the sufentanil group and one from each of the other groups) developed transient hypotension during induction of anesthesia. It is concluded that all three opioids can provide satisfactory anesthesia for patients having valve replacement surgery.