舒芬太尼与瑞芬太尼/舒芬太尼对微创心脏手术患者术后镇痛与并发症影响的倾向性评分匹配研究

doi:10.3969/j.issn.1001-8131.2025.03.005

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Abstract Objective To retrospectively analyze the impact of using sufentanil alone versus sufentanil in combination with remifentanil on postoperative analgesia and complications in patients undergoing minimally invasive cardiac surgery. Methods Select right axillary small incision minimally invasive heart valve surgery patients,according to the intraoperative anesthesia analgesia scheme into sufentanil group and sufentanil combined remifentanil group,using the nearest matching method,and 1:1 matching,set the caliper value of 0.02,to compare the two groups of postoperative extubation time,ICU stay time,remedial analgesia,NRS score and postoperative complications. Results A total of 354 patients were screened and 82 patients(41 pairs)were successfully matched.The difference of ICU stay,CPOT score,and postoperative complications between the two groups(P>0.05);the dose(morphine equivalent)of sufentanil and remifentanil was significantly higher than that of sufentanil group(P<0.05),and the ICU NRS score of sufentanil group,ICU salvage analgesia,ward NRS score,and ward remedial analgesia were significantly lower than those of sufentanil group,respectively(P<0.05). Conclusion In right axillary small incision cardiac surgery,compared with the use of low-dose sufentanil combined with remifentanil,the use of high-dose sufentanil alone can provide better perioperative analgesia.However,there was no significant difference between the two analgesia regimens in terms of post-extubation time and postoperative atelectasis and other complications.

Key words： Minimally invasive cardiac surgery Sufentanil Remifentanil

Received: 03 March 2025

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R614

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	Pan Lin
	Wei Hanwei

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Pan Lin,Wei Hanwei. The Association of Sufentanil and Remifentanil/Sufentanil on Postoperative Analgesia and Complications in Patients with Minimally Invasive Cardiac Surgery:A Propensity Score-matching Study[J]. journal1, 2025, 45(3): 18-21.

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http://www.hrbyybjb.org.cn/EN/10.3969/j.issn.1001-8131.2025.03.005 OR http://www.hrbyybjb.org.cn/EN/Y2025/V45/I3/18

[1] WILLIAMS J B,MCCONNELL G,ALLENDER J E,et al.One-year results from the first US-based enhanced recovery after cardiac surgery(ERAS Cardiac)program[J].J Thorac Cardiovasc Surg,2019,157(5): 1881-1888.
[2] ITO T,MAEKAWA A,HOSHINO S,et al.Three-port(one incision plus two-port)endoscopic mitral valve surgery without robotic assistance[J].Eur J Cardiothorac Surg,2017,51(5): 913-918.
[3] SLIM K.Fast-track surgery:the next revolution in surgical care following laparoscopy[J].ColorectalDis,2011,13(5):478-80.
[4] GRECO M,LANDONI G,BIONDI-ZOCCAI G,et al.Re-mifentanil in cardiac surgery:a meta-analysis of rando-mized controlled trials[J].J Cardiothorac Vasc Anesth,2012,26(1):110-6.
[5] 封居冕,王怀贞,彭亮明,等.右美托咪定复合舒芬太尼在婴幼儿超快通道心脏麻醉中的应用[J].临床小儿外科杂志,2020,19(11):1032-1037.
[6] 阳婷婷,唐轶洋,张兴安.舒芬太尼与瑞芬太尼复合丙泊酚全凭静脉麻醉用于神经外科手术效果与安全性的系统评价[J].中国循证医学杂志,2013,13(12):1492-1499.
[7] KHANYKIN B,SIDDIQI R,JENSEN P F,et al.Comparison of remifentanil and low-dose fentanyl for fast-track cardiac anesthesia: a prospective randomized study[J].Heart Surg Forum,2013,16(6):E324-8.
[8] YU E H,TRAN D H,LAM S W,et al.Remifentanil tolerance and hyperalgesia: short-term gain,long-term pain[J].Anaesthesia,2016,71(11):1347-1362.
[9] WOOLF C J,SALTER M W.Neuronal plasticity: increasing the gain in pain[J].Science,2000,288(5472): 1765-9.
[10] SUN Y,ZHANG W,LIU Y,et al.Intrathecal injection of JWH015 attenuates remifentanil-induced postoperative hyperalgesia by inhibiting activation of spinal glia in a rat model[J].Anesthesia and analgesia,2014,118(4):841-53.
[11] KOO C H,CHO Y J,HONG D M,et al.Influence of high-dose intraoperative remifentanil with intravenous ibuprofen on postoperative morphine consumption in patients und-ergoing pancreaticoduodenectomy:a randomized trial[J].Journalofclinicalanesthesia,2016,35:47-53
[12] YUAN Y,SUN Z,CHEN Y,et al.Prevention of Remifentanil Induced Postoperative Hyperalgesia by Dexmedetomidine via Regulating the Trafficking and Function of Spinal NMDA Receptors as well as PKC and CaMKII Level In Vivo and In Vitro[J].PLoS One,2017,12(2):0171348.
[13] ZHU Y,WANG Y,DU B,et al.Could remifentanil reduce duration of mechanical ventilation in comparison with other opioids for mechanically ventilated patients A systematic review and meta-analysis[J].Critical care(London,England),2017,21(1):206.
[14] 杨禹,叶聪,杨承志,等.全胸腔镜下单纯左心耳闭合术预防非瓣膜性房颤合并高出血风险患者相关脑卒中的临床研究[J].首都医科大学学报,2023,44(05):795-802.
[15] 周孝道,龚红君,马驰波.帕瑞昔布钠对瑞芬太尼快通道麻醉患者术后苏醒期影响的效果分析[J].中国临床药理学杂志,2015,31(09):708-711.
[16] 张铁铮,武翔.加速康复心脏外科的回顾与展望[J].临床麻醉学杂志,2020,36(10):944-947.
[17] YU L S,XIE W P,LIU J F,et al.A comparison of the outcomes of dexmedetomidine and remifentanil with sufentanil-based general anesthesia in pediatric patients for the transthoracic device closure of ventricular septal defects[J].JCardiothoracSurg,2021,16(1):111.
[18] YU L S,LEI Y Q,LIU J F,et al.Remifentanil-based fast-track cardiac anesthesia combined with the postoperative serratus anterior plane block for transthoracic device closure of atrial septal defect in pediatric patients[J].J Card Surg,2021,36(7):2263-2268.
[19] 蒋神杰,滕浩康,严美娟.等.右美托咪定复合罗哌卡因胸肌筋膜平面阻滞用于右侧腋下小切口微创心脏瓣膜手术中超快通道麻醉效果[J].浙江医学,2022,44(15):1627-1631.