Comparision Of Three Opioids On Hemodynamic Influence Of Perioperative Phase In Senile Patients' Surgery

Background:Anesthetic quality is the key to ensuring the safety of intraoperative patient factors,the qualities including anesthesia surgery in patients with stable vital signs,environmental stability and no pain,also including patients with general anesthesia unconscious and memory disappearing,when it stop,wake up fast and smooth after anesthesia,the satisfaction of the patient and the cost of anesthesia,as well as to meet the requirements of the surgeon.The successful key of anesthesia lies in the quality of it,with the development of surgery,different informations from different aspects to study the effect of anesthesia quality safety of anesthesia,however,much more from the anesthetic preparation,the choice of anesthetic methods or drugs from different aspects,such as by observing the clinical summary to obtain certain experience,it is lack of systemic research on the quality of anesthesia methods which affect anesthesia,the quality of anesthesia affected by many factors,therefore,this study related to narcotic drugs and continuous anesthesia explored the reasons affecting the quality of anesthesia and improving the anesthetic quality.Objective:To compare fentanyl?sufentanil and remifentanil on hemodynamics and recovery phase in senile patient's surgery.Subjects and Methods:According to the operation of different opioids,the elderly patients will be divided into three groups at random:fentanyl group?34 cases?,sufentanil group?44cases?and remifentanil group?44 cases?.After checking informations of the patient into the operating room at first,open venous pathway and connect routine monitorings such as:dynamic electrocardiogram?ECG?monitoring,continuous monitoring heart rate?HR?,systolic blood pressure?SBP?,diastolic blood pressure?DBP?and monitor the bispectral index?BIS?,tropisetron 5.64mg and scopolamine 0.3mg intravenous injection.In accordance with the requirements for routine preparations of the operation,the patients of fentanyl group up to settle midazolam 0.1mg/kg,propofol2mg/kg,fentanyl 5?g/kg,intravenous injection;the patients of sufentanil group up to settle midazolam 0.1mg/kg,propofol 2mg/kg,sufentanil 0.5?g/kg,intravenous injection;the patients of remifentanil group up to settle midazolam 0.1mg/kg,propofol 2mg/kg,remifentanil 0.5?g/kg,intravenous injection too.When the patients were performed being consciousness disappearing,three groups of vecuronim bromide 0.1mg/kg for injection,pure oxygen mask auxiliary ventilation for 3 minutes,when the consciousness disappeared?unconsciousness criterion:eyelash reflex disappearing,respond to verbal instructions without any reaction,nonrespond to push the shoulder?,began tracheal intubation and mechanical ventilation.The patient home test tube of left radial artery blood pressure under local anesthesia,record the time before anaesthesia?T₁?,the time on operation is over?T₂?,decannulation time?T₃?and the time after decannulation for 10 minutes?T₄?,record four time points of systolic blood pressure?SBP?,diastolic blood pressure?DBP?,heart rate?HR?,blood oxygen saturation?SPO₂?,record the general anesthetics dosage and anesthesia recovery agitation,choking cough,nausea,vomiting,respiratory depression,pain,and the cause of cardiovascular events,the number of cases.Result:1.The three groups of the patients'age,weight,sex ratio,ASA grade,had no statistical difference?P>0.05?.2.Three groups of patients with tube drawing when the systolic pressure,diastolic blood pressure and heart rate were more significantly increased before anesthesia?P<0.05?,10 minutes after extubation,the blood pressure change of fentanyl group is more severe than sufentanil?P<0.05?.3.Compared with fentanyl group,the sufentanil group's decannulation time is shorter,VAS score is lower?P<0.05?;4.Stir,choking cough,cardiovascular events,and respiratory depression 30 min requirements such as stress response and postoperative analgesia treatment cases of sufentanil group and remifentanil group were significantly lower than that of fentanyl group?P<0.05?.Incidence of adverse drug reactions of sufentanil group was obviously lower than that of fentanyl group?P<0.05?.Conclusion:1.Compared the anesthesia effect of the three kinds of objects'study,the effect of sufentanil and remifentanil is superior to fentanyl,they can provide more smoothly hemodynamic environment around the time of decannulation,reduce the awaken time and extubation time,at the same time reducing the pain occurrence of the awakening period,restlessness and the occurrence of stress reaction.2.Remifentanil for postoperative awaken time and extubation time were shorter than sufentanil,but slightly less in terms of stress reaction than sufentanil.