舒芬太尼快通道心脏麻醉方案对先天性心脏病患儿Narcotrend指数及血流动力学的影响

Effect of sufentanil-based fast-track cardiac anesthesia on Narcotrend index and hemodynamics in children with congenital heart disease

摘要:

目的 观察舒芬太尼快通道麻醉方案对先天性心脏病（CHD）患儿Narcotrend指数及血流动力学的影响。方法 回顾性分析2022年6月—2024年6月徐州医科大学附属徐州儿童医院102例行手术治疗的CHD患儿的临床资料，根据麻醉方式不同将其分成对照组（常规麻醉）和观察组（舒芬太尼快通道心脏麻醉），各51例。比较两组患儿术前（T₀）、气管插入后（T₁）、手术1 h（T₂）和术毕（T₃）的Narcotrend指数、心率（HR）、平均动脉压（MAP）和血氧饱和度（SpO₂），观察不良事件发生情况及康复进程。结果 两组患儿不同时间点的Narcotrend指数、HR、MAP比较，差异有统计学意义（P <0.05）；不同时间点的SpO₂比较，差异无统计学意义（P >0.05）。两组患儿的Narcotrend指数、HR、MAP比较，差异有统计学意义（P <0.05）；两组的SpO₂比较，差异无统计学意义（P >0.05）。两组患儿的Narcotrend指数、HR、MAP变化趋势比较，差异有统计学意义（P <0.05）；两组SpO₂变化趋势比较，差异无统计学意义（P >0.05）。观察组不良反应总发生率低于对照组（P <0.05）。观察组的自主呼吸时间、拔管时间、恢复进食时间、ICU停留时间、住院时间均短于对照组（P <0.05）。结论 舒芬太尼快通道心脏麻醉方案在CHD患儿中应用效果较好，可快速达到深度镇静的效果，维持血流动力学稳定，不良事件发生较少，有利于患儿术后康复。

Abstract:

Objective To observe the effect of sufentanil-based fast-track cardiac anesthesia on Narcotrend index and hemodynamics in children with congenital heart disease (CHD).Methods A total of 102 children who underwent surgery for CHD in the hospital between June 2022 and June 2024 were selected with retrospectively analyzing their data, and divided into the control group (conventional anesthesia) and the observation group (sufentanil-based fast-track cardiac anesthesia) according to different anesthesia methods, with 51 cases in each group. Narcotrend index, heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO₂) before surgery (T₀), after intubation (T₁), 1 h after the beginning of surgery (T₂) and at the end of surgery (T₃) were compared between groups. The incidence of adverse events and rehabilitation process were observed.Results The differences were statistically significant when comparing Narcotrend index, HR, and MAP at different time points (P < 0.05, respectively), and the difference was not statistically significant when comparing SpO₂ at different time points (P > 0.05). The differences in Narcotrend index, HR, and MAP between the two groups were statistically significant (P < 0.05), and the difference in SpO₂ between the two groups was not statistically significant (P > 0.05). Comparing the trends of Narcotrend index, HR, and MAP in the two groups, the difference was statistically significant (P < 0.05), and comparing the trends of SpO₂ in the two groups, the difference was not statistically significant (P > 0.05); the incidence rate of total adverse reactions in the observation group was lower than that in the control group (P < 0.05); autonomous breathing time, extubation time, resumption of feeding time, ICU stay, and hospitalisation time in the observation group were shorter than those in the control group (P < 0.05).Conclusion Applying sufentanil-based fast-track cardiac anesthesia to children undergoing surgery for CHD can quickly achieve deep sedation and maintain hemodynamic stability, with few adverse events. It is conducive to postoperative recovery of the children.