Department of Anesthesiology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Medicine, Graduate School, Nanchang University, Nanchang, China.
J Clin Lab Anal. 2019 Oct;33(8):e22971. doi: 10.1002/jcla.22971. Epub 2019 Aug 2.
The aim of this study was to explore whether remifentanil could inhibit the stress response in emergent trauma surgery more effectively than sufentanil.
Sixty trauma patients for emergent surgery were randomly divided into remifentanil group (R group, n = 30) or sufentanil group (S group, n = 30). The patients in the R group were continuously intravenously infused with remifentanil, while those in the S group were administrated with sufentanil. The plasma contents of cortisol (COR), epinephrine (E), norepinephrine (NE), and blood glucose were measured before anesthesia induction (T1), 5 minutes after intratracheal intubation (T2) and 5 minutes (T3), 30 minutes (T4), and 1 hour (T5) after surgery, respectively. The blood pressure (BP) and the heart rate (HR) at these time points were recorded as well.
The results showed that the patients in the R group had more stable hemodynamics during the surgery and had a significantly lower HR at T2-T5 than those in the S group. The plasma levels of norepinephrine at time points T3-T5 and levels of cortisol at T4-T5 in the R group were significantly lower than those in the S group (P < 0.05).
The results in the present study indicated that remifentanil could inhibit the stress response in emergent trauma surgery patients more effectively than sufentanil.
本研究旨在探讨瑞芬太尼是否比舒芬太尼更能有效抑制急诊创伤手术中的应激反应。
60 例急诊手术创伤患者随机分为瑞芬太尼组（R 组，n=30）和舒芬太尼组（S 组，n=30）。R 组患者持续静脉输注瑞芬太尼，S 组患者给予舒芬太尼。分别于麻醉诱导前（T1）、气管插管后 5 分钟（T2）、手术 5 分钟（T3）、30 分钟（T4）和 1 小时（T5）时测量血浆皮质醇（COR）、肾上腺素（E）、去甲肾上腺素（NE）和血糖含量，并记录各时间点的血压（BP）和心率（HR）。
结果显示，R 组患者在手术过程中血流动力学更稳定，T2-T5 时心率明显低于 S 组。R 组患者 T3-T5 时去甲肾上腺素水平和 T4-T5 时皮质醇水平明显低于 S 组（P<0.05）。
本研究结果表明，瑞芬太尼比舒芬太尼更能有效抑制急诊创伤手术患者的应激反应。
