靶控输注舒芬太尼及芬太尼对丙泊酚药效学的影响

Effect of TCI with sufentanil or fentanyl on pharmacodynamics of propofol

目的探讨靶控输注(TCI)舒芬太尼及芬太尼对丙泊酚药效学的影响。方法30例择期全麻下行妇科腹腔镜手术患者,随机均分为两组:与丙泊酚复合应用的舒芬太尼TCI为0.5 ng/ml(SF组);芬太尼为2.5 ng/ml(F组)。观察麻醉期血液动力学改变、泵注丙泊酚的入睡时间、BIS降至60的时间、停药后患者的拔管时间、睁眼时间、定向力恢复时间、OAA/S评分及术后24 h并发症。结果(1)F组麻醉诱导时的SBP、DBP低于SF组(P<0.05);两组在麻醉诱导时HR比麻醉前均显著降低(P<0.05);F组在手术开始时的SBP、DBP、MAP高于SF组(P<0.05);F组拔管期的SBP、DBP均高于SF组(P<0.05);(2)SF组的入睡时间明显短于F组(P<0.05);停止丙泊酚后306、0 min SF组的OAA/S评分低于F组(P<0.05);(3)SF组术后24 h躁动发生率、主诉需要阿片类药物少于F组(P<0.05)。结论舒芬太尼丙泊酚TCI入睡快,围术期血液动力学更加平稳。

Objective To explore the effect of TCI with sufentanil or fentanyl on pharmacody- namics of propofol. Methods Thirty patients undergoing elective gynaeeologic laparoscopy were randomly divided into two groups：Group SF received TIVA with propofol 3 μg/ml and sufentanil 0.5 ng/ml; Group F propofol 3 μg/ml and fentanyl 2.5 ng/ml. The hemodynamics recovery profiles and the complications were compared. Results （1）The heart rates of both groups during induction were significantly lower than those before anaeshesia. The depressive effect on blood pressure was seen more in group F than in group SF（P〈0.05）. （2）Time to fall asleep in group SF was significantly shorter than that in group F（P〈0.05）. At 30,60 min after propofol were OAA/S scores of group SF were lower than those of group F（P〈0.05）. （3）The rates of restlessness of group SF were lower than that of group F（P〈0.05）. Conclusion Compared with fentanyl/propofol TCI-based anaesthesia,sufentailnil/propofol TCI-based anaesthesia is associated with better hemodynamic stability and less painful complications.