Department of Anesthesiology, King Fahd Hospital, University of Dammam, Al Khubar, Saudi Arabia.
J Cardiothorac Vasc Anesth. 2013 Feb;27(1):63-70. doi: 10.1053/j.jvca.2012.01.023. Epub 2012 Mar 8.
To test the ability of low sufentanil effect-site concentrations (Ce) to shorten the time to tracheal extubation after valve surgery.
A prospective, randomized, blinded, controlled study.
A single university hospital.
Forty-eight patients scheduled for valve surgery under target-controlled propofol infusion.
After ethical committee approval, patients were allocated randomly to receive sufentanil concentrations of 0.2, 0.3, or 0.4 ng/mL (n = 16 per group) during target-controlled propofol infusion.
Times to spontaneous eye opening, return of spontaneous breathing and extubation; number of changes and cumulative doses of propofol and sufentanil; incidences of light anesthesia and myocardial ischemia; intensive care unit and hospital stays; and costs of propofol, sufentanil, and ventilation were recorded. Compared with the sufentanil 0.4-ng/mL group, 0.2- and 0.3-ng/mL groups had shorter times to eye opening (24.8 min [SD 7.8] and 52.6 min [12.5] v 85.6 min [10.0], respectively), spontaneous breathing (32.7 min [19.9] and 70.1 min [27.2] v 137.5 min [20.8], respectively), and extubation (112.2 min [16.9] and 161.9 min [32.9] v 271.3 min [27.4], respectively; p < 0.001), more frequent changes in propofol concentrations (p < 0.001), higher cumulative propofol doses, lower cumulative sufentanil doses, and 33% to 44% lower total cost (p < 0.001). Incidences of light anesthesia and myocardial ischemia and intensive care unit and hospital stays were similar for all groups.
Compared with sufentanil Ce of 0.4 ng/mL, lower concentrations (0.2 and 0.3 ng/mL) promoted faster recovery and shorter times to extubation after valve surgery performed under target-controlled propofol infusion.
测试低舒芬太尼效应室浓度（Ce）缩短瓣膜手术后气管拔管时间的能力。
前瞻性、随机、盲法、对照研究。
一所大学医院。
48 例行靶控异丙酚输注下瓣膜手术的患者。
在伦理委员会批准后，患者随机分配接受舒芬太尼浓度为 0.2、0.3 或 0.4ng/ml（每组 16 例）。
自主睁眼、自主呼吸恢复和拔管时间；异丙酚和舒芬太尼的变化次数和累积剂量；轻度麻醉和心肌缺血的发生率；重症监护病房和住院时间；以及异丙酚、舒芬太尼和通气的费用。与舒芬太尼 0.4ng/ml 组相比，0.2ng/ml 和 0.3ng/ml 组睁眼时间更短（24.8 分钟[7.8 秒]和 52.6 分钟[12.5 秒]，分别；85.6 分钟[10.0 秒]）、自主呼吸时间更短（32.7 分钟[19.9 秒]和 70.1 分钟[27.2 秒]，分别；137.5 分钟[20.8 秒]）、拔管时间更短（112.2 分钟[16.9 秒]和 161.9 分钟[32.9 秒]，分别；271.3 分钟[27.4 秒]）；异丙酚浓度变化更频繁（p<0.001）；累积异丙酚剂量更高，累积舒芬太尼剂量更低；总费用降低 33%至 44%（p<0.001）。各组轻度麻醉和心肌缺血的发生率以及重症监护病房和住院时间相似。
与舒芬太尼 Ce 为 0.4ng/ml 相比，较低浓度（0.2 和 0.3ng/ml）可促进靶控输注异丙酚下瓣膜手术后更快的恢复和拔管时间。
