舒芬太尼与丙泊酚联合麻醉对腹腔镜子宫切除术的效果观察

Efficacy of Different Doses of Sufentanil Combined with Propofol Continuous Infusion for Laparoscopic Hysterectomy

目的:探讨不同剂量舒芬太尼联合丙泊酚麻醉对腹腔镜下子宫切除术的效果。方法拟行腹腔镜下子宫切除术120例随机分为三组(S1、S2、S3)。术中采用持续输注舒芬太尼和丙泊酚5~10mg.kg-1.h-1维持麻醉,S1组输注舒芬太尼0.2μg.kg-1.h-1、S2组输注舒芬太尼0.4μg.kg-1.h-1、S3组输注舒芬太尼0.6μg.kg-1.h-1。记录舒芬太尼和丙泊酚使用情况;MAP、HR、自主呼吸恢复时间、清醒时间、出现疼痛时间;术中知晓,苏醒时躁动、呕心/呕吐、疼痛发生情况。结果①S3组舒芬太尼量高于S2组与S1组,丙泊酚量低于S2和S1组(P<0.05);S3组术中推注10μg舒芬太尼例数和次数低于S2组和S1组,S2组低于S1组(<0.05)。②各组同时点MAP和HR无统计学意义(>0.05);组内比较,各组T1时点MAP和HR均低于T0及其它时点(<0.05);③S3组自主呼吸恢复时间、苏醒时间及出现疼痛时间长于S1组与S2组(<0.05);④S3组苏醒时疼痛发生率低于S1组和S2组(<0.05)。结论术中持续输注舒芬太尼联合丙泊酚全凭静脉麻醉可为腹腔镜下子宫切除提供满意的麻醉效果,增加舒芬太尼输注剂量,可提供更加稳定的血流动力学和良好的术后镇痛。

Objective To evaluate the efficacy of dif erent doses of sufentanil combined with propofol continuous infusion for total intravenous anesthesia in laparoscopic hysterectomy.Methods The 120 patients undergoing laparoscopic hysterectomy were randomly divided into 3 groups(n=40):S1 group,S2 group and S3 group.Anesthesia was maintained with sufentanil and propofol 5~10mg.kg-1.h-1 continuous infusion;S1 group,S2 group,and S3 group received respectively sufentanil 0.2μg.kg-1.h-1,0.4μg.kg-1.h-1 and 0.6μg.kg-1.h-1.The consumption of sufentanil and propofol were recorded;MAP and HR were recorded;Times to spontaneous ventilation,recovery and pain were record;the incidences of awareness in the intraoperative period,dysphoria,nausea and vomiting,pain in recovery period were record.Results(1)Total sufentanil consumption in S3 group was more than in S1 and S2 group,Total propofol consumption and The bolus of 10?g sufentanil requirement in S3 group was less than in S1 and S2 group(<0.05).(2)There were no statistical y dif erence in MAP and HR at the same time in three groups(>0.05);MAP and HR at T1 time in three group was less than at other dif erent time(<0.05).(3)The time of spontaneous ventilation,recovery and pain in S3 group were longer than in S1 and S2 group(<0.05).(4)The incidence of pain in S3 group is lower than in S1 and S2 groups after recovery.Conclusion Sufentanil combined with propofol continuous infusion was suitable for maintaining adequate anesthesia in laparoscopic hysterectomy.With increasing dose of sufentanil,it can provide more stable haemodynamics and excellent post-operative analgesia.