瑞吩坦尼與低劑量吩坦尼用於微創心臟手術病患術後恢復之比較

A Comparison of Remifentanil and Low Dose Fentanyl for Postoperative Recovery Profile in Patients Undergoing Minimally Invasive Cardiac Surgery

簡介：術後加速康復為近來心臟手術病人照護之發展方向。除了微創手術方式使用，短效的麻醉藥物是術後加速康復中重要的一環。瑞吩坦尼是一極短效的鴉片類止痛藥，因此我們比較術中使用瑞吩坦尼與低劑量吩坦尼對微創心臟手術病人恢復速度之影響。方法：此研究為一回溯性研究，比較分析2018年五月至八月間進行微創心臟手術的病人術後拔管速度、住院天數、術後止痛藥使用量、疼痛指數與併發症比例。結果：共有53名病患納入研究，33名為瑞吩坦尼組，20名為吩坦尼組。結果兩組病人術後拔管時間、住院天數、術後止痛藥使用量、疼痛指數與併發症比例皆無顯著差異。結論：我們認為瑞吩坦尼可安全地用於微創心臟手術並提供病人快速恢復。

 

Background: The concept of enhanced recovery after surgery (ERAS) is flourishing in multiple specialties, including cardiac surgery. Beside minimally invasive surgical approach, short acting anesthetic agent is one of the major components of ERAS programs. Remifentanil is an ultrashort acting opioid agent. The purpose of this study was to compare remifentanil and low dose fentanyl for postoperative recovery profile in patients undergoing minimally invasive cardiac surgery (MICS). Methods: This study was a retrospective study. We compared the recovery profile including extubation time after surgery, length of hospital stay, postoperative morphine consumption, pain scores and in hospital complication rate between patients undergoing elective MICS from May to August 2018. Results: Fifty-three patients were enrolled in this study, 33 of them were in group remifentanil (G. remifentanil) and 20 were in group fentanyl (G. fentanyl). The extubation times, average hospital stay, postoperative morphine consumption, pain scores and in hospital complication rate were all similar between both groups. Conclusion: We consider remifentanil can be safely used in MICS and provides similar recovery profile as low dose fentanyl.