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与芬太尼相比,雷米芬坦尼在胸腔镜食道切除术中降低了诱导后低血压:一项回顾性队列研究

Jin Zhang¹, Chen Zhao², Hao Sun²

¹Department of Anesthesiology, The Second Hospital of Nanjing, Nanjing, Jiangsu, China.

Frontiers in pharmacology

|October 27, 2025

概括

与芬太尼相比,雷米芬坦尼尔诱导显著降低了接受胸腔镜食道切除术的患者的诱导后低血压 (PIH) 风险. 雷米芬坦尼尔还可以改善麻醉诱导期间的血液动力稳定性.

科学领域:

麻醉学麻醉学
心血管麻醉心血管麻醉
胸部麻醉胸部麻醉

背景情况:

诱导后低血压 (PIH) 是常见的麻醉并发症,特别是在接受胸腔镜食道切除术的高风险患者中.
阿片类药物选择会影响血液动力稳定,但对PIH风险的比较数据有限.
老年人,营养不良,并发病患者特别容易受到PIH的影响.

研究的目的:

为了比较ETOMIDATE-remifentanil和ETOMIDATE-fentanyl麻醉诱导方案之间的PIH发生率.
评估不同阿片类诱导剂对经过胸腔镜食道切除术的患者血液动力稳定性的影响.
分析混因素,并确保对PIH风险进行可靠的初级结果分析.

主要方法:

对289名接受胸腔镜食道切除术的患者进行了回顾性队列研究.
使用埃托米达特加上芬太尼或雷米芬坦尼尔的麻醉诱导.
后勤回归和LASSO回归用于共变量选择和PIH关联分析.
在诱导后的头15分钟内分析血液动力学变化 (BP,MAP,HR) 的概括估计方程.

主要成果:

雷米芬坦尼尔 (23.7%) 与芬太尼尔 (42.3%) (P=0.001) 的PIH发生率明显较低.
雷米芬坦尼尔与更稳定的血液动力学有关,包括减弱的缩血压下降.
雷米芬坦尼尔治疗时,勃拉迪心的发生频率更高,而芬坦尼尔治疗时,输管后高血压的发生率更高.

结论:

基于雷米芬坦尼尔的麻醉诱导与胸腔镜食道切除术中的PIH风险降低有关.
与芬太尼相比,雷米芬坦尼尔在此过程的诱导过程中增强了血液动力稳定性.
这些发现支持remifentanil作为一种潜在的更安全的诱导剂,用于接受胸腔镜食道切除术的高风险患者.

关键词:

麻醉是一种麻醉.芬太尼 (Fentanyl) 是一种药物.感应感应感应是一种感应感应.在诱导后的低血压.雷米芬坦尼尔的使用方法胸腔镜食道切除术胸腔镜食道切除术

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