背景：接受心脏手术患者日益增加，而在心脏手术围术期的镇痛药物使用中，瑞芬太尼相对其它镇痛药物具有独特的优势，因此该药在心脏手术围术期中应用广泛。目的：对有关瑞芬太尼的论著进行归纳总结，阐述其在心脏手术围术期的应用进展。内容及趋势：瑞芬太尼具有独特的药物代谢动力学特点，加上其心血管的保护作用使之成为肝、肾或心功能不良患者的推荐用药。瑞芬太尼不仅在心脏手术中有对抗术中的应激刺激、加快术后恢复、提前脱离机械通气以及拔管时间等优势，也常用于心血管微创手术和经食管超声心动图等诊断性操作中。此外，瑞芬太尼可缩短心脏重症监护病房患者持续用药后气管拔管的时间。总的来说，瑞芬太尼凭借其特性在心脏手术围术期中发挥着重要的作用。
Background: Remifentanil has been applied in more and more cardiac operation because of several advantages not observed in other analgesics. Objective: Explain the role of remifentanil in cardiac surgical preoperative period by summarizing articles about remifentanil. Content & Trend: Because of the unique pharmacokinetic profile and potential protective cardiac preconditioning effect, remifentanil is recommended even in patients with renal impairment, hepatic dysfunction or poor cardiovascular function. The potential benefits of remifentanil in cardiac surgery not only include protection against intraoperative stressful stimulus, but also rapid postoperative recovery, early weaning from mechanical ventilation, and extubation. Remifentanil has also been often applied in minimally invasive cardiologic techniques or diagnostic procedures such as transesophageal echocardiography as a ideal sedative agents. Remifentanil can reduce the time to tracheal extubation after cessation of the continuous infusion in ICU. In conclusion, remifentanil will play a major role in cardiac surgical preoperative period.
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