Department of Anaesthesiology and Intensive Care Medicine, Heart Center Leipzig, Leipzig, Germany.
University Department for Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Anaesthesia. 2019 May;74(5):602-608. doi: 10.1111/anae.14572. Epub 2019 Jan 20.
We retrospectively compared patients receiving remifentanil with patients receiving sufentanil undergoing fast-track cardiac surgery. After 1:1 propensity score matching there were 609 patients in each group. The sufentanil group had a significantly longer mean (SD) ventilation time compared with the remifentanil group; 122 (59) vs. 80 (44) min, p < 0.001 and longer mean (SD) length of stay in the recovery area; 277 (77) vs. 263 (78) min, p = 0.002. The sufentanil group had a lower mean (SD) visual analogue pain score than the remifentanil group; 1.5 (1.2) vs. 2.4 (1.5), p < 0.001 and consumed less mean (SD) piritramide (an opioid analgesic used in our hospital); 2.6 (4.7) vs. 18.9 (7.3) mg, p < 0.001. The results of our study show that although remifentanil was more effective in reducing time to tracheal extubation and length of stay in the recovery area, there was an increased requirement for postoperative analgesia when remifentanil was used.
我们回顾性比较了接受瑞芬太尼和舒芬太尼的快速通道心脏手术患者。经过 1:1 倾向评分匹配后,每组有 609 例患者。与瑞芬太尼组相比,舒芬太尼组的通气时间明显更长,平均(SD)为 122(59)min 比 80(44)min,p<0.001,且恢复区停留时间也更长,平均(SD)为 277(77)min 比 263(78)min,p=0.002。舒芬太尼组的平均(SD)视觉模拟疼痛评分低于瑞芬太尼组,为 1.5(1.2)比 2.4(1.5),p<0.001,且哌替啶(我院使用的一种阿片类镇痛药)用量也更少,平均(SD)为 2.6(4.7)mg 比 18.9(7.3)mg,p<0.001。我们的研究结果表明,虽然瑞芬太尼在减少气管拔管时间和恢复区停留时间方面更有效,但使用瑞芬太尼时术后镇痛需求增加。