关键词: 老年患者, 舒芬太尼, 腹腔镜胆囊切除术

Abstract:

Objective：To explore the anesthetic effect of sufentanil on elderly patients with laparoscopic cholecystectomy.
Methods：One hundred and eighty elderly patients undergoing laparoscopic cholecystectomy were randomly divided into 3 groups：group F（fentanyl with dosage of 20 μg/kg），group S1（sufentanil with dosage of 0.5 μg/kg）and group S2（sufentanil with dosage of 1μg/kg）. Systolic blood pressure （SBP），diastolic blood pressure （DBP），mean blood pressure （MBP），heart rate（HR）， electrocardiogram（ECG）and pulse oxygen saturation（SpO2）at 6 time points（Respectively，10 minutes after sedation，instant of anesthesia induction，3 minsutes after endotracheal intubation，instant of carbon dioxide pneumoperitoneum，15 minutes after carbon
dioxide pneumoperitoneum and postoperative）were recorded and examined. The breathing recovery time，early wake up time and the time of air duct removal，the hemodynamic parameters of extubation，as well as the complications in 3 groups were compared. Results：Compared with group F，hemodynamics fluctuated more slightly in endotracheal intubation and around carbon dioxide pneumoperitoneum in group S1 and S2，without significant difference between S1 and S2. There was no differences in the breathing recovery time，the early wake up time and the time of air duct removal between group S1 and F. Compared with group F，hemodynamics were more stable and with less complications at air duct removal in group S1. However，spontaneous breathing recovery time extended obviously in group S2，and some patients in group S2 required additional opioid antagonist medicine which
brought fret and involuntary physical activity. Conclusion：Application of 0.5 μg/kg sufentanil in laparoscopic cholecystectomy in elderly patients could reduce the emergency responses induced by endotracheal intubation and CO2 pneumoperitoneum，maintain stable hemodynamics and would not affect the postoperative palinesthesia.

Key words: elderly patients, sufentanil, laparoscopic cholecystectomy